Four U.S. states that mandated more frequent syphilis screening during pregnancy and at delivery had increased case detection rates, but the effect waned in the year after those laws took effect, according to an observational study of more than 16 million live births. [MEDPAGE TODAY]

As congenital syphilis cases surge, state mandates may not be enough to keep detection rates up.

In the first quarter after enacting expanded prenatal syphilis screening mandates, Arizona, Georgia, Louisiana, and Michigan together saw the incidence of maternal syphilis case detection increase by 26% (P=0.02), reported Jessica Cohen, PhD, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues.

This translated to an overall difference-in-difference estimate of 19.5% more cases detected per quarter -- or 32.2 additional cases per 100,000 live births -- with the mandate than without it (P=0.04), the research team detailed in JAMA Health Forum.

That positive detection bump faded in the year after the mandates' enactment, however. After the first quarter's significant increase, the next three quarters trended toward an 11% increase without reaching statistical significance (P=0.48).

"Our study suggests that mandates can generate a meaningful boost in case detection after they are enacted, but that it may be short-lived," co-author Sara Baum, also of Harvard T.H. Chan School of Public Health, told MedPage Today. "Mandates alone may not come with the complementary supports needed for clinicians and patients to generate sustained impact."

Congenital syphilis transmitted during pregnancy from mothers to babies can increase the risk of stillbirth, neonatal death, and low birth weight. After reaching historic lows in the early 2000s, U.S. congenital syphilis rates have spiked -- climbing from 8.7 cases per 100,000 live births in 2013 to 105.8 cases per 100,000 in 2023.

More>

###