USPSTF releases draft recommendation on syphilis screening in pregnant women

Chien Wen-Tseng
Chien-Wen Tseng

The U.S. Preventive Services Task Force has issued a draft recommendation affirming its 2009 decision that all women who are pregnant should be screened for syphilis.

The “A” grade is only the 16th time out of 98 total recommendations that the USPSTF has issued this particular grade for a specific preventive service.

According to the USPSTF, despite many groups, including AAFP, echoing similar screening recommendations and many states mandating screening for syphilis infection at some point during gestation, incidence rates of primary and secondary syphilis infection in women and congenital syphilis in their offspring are rising.

Chien-Wen Tseng, MD, MPH, MSEE, of the department of family medicine and community health at the University of Hawaii and a USPSTF member, told Healio Family Medicine about the two-way conversation that primary care physicians and patients can have regarding this draft recommendation.

“[PCPs] should talk to all their pregnant patients about the importance of early screening for syphilis as part of routine prenatal care to keep women and their babies healthy. Women may have syphilis and not know it because early syphilis may cause no or few symptoms. Screening involves a simple blood test and treatment is with a common antibiotic,” she said. “Any woman who is concerned that she may have syphilis, or that she is at risk for passing syphilis to her baby at any time during or after her pregnancy, should talk about this with her doctor.”

Tseng said passing syphilis to fetuses during pregnancy could lead to “disastrous consequences” such as miscarriage, premature birth, the baby’s death after birth or severe birth defects.

Some research gaps still exist despite the “A” recommendation, she added.

“Additional research on … studies that compare different screening methods; identify the most effective times during pregnancy to provide repeat screenings and which higher risk populations should be rescreened; and assess the effectiveness and safety of treatment options aside from penicillin … would be worthwhile,” Tseng said.

The USPSTF’s draft statement and evidence review has been posted for public comment on the USPSTF website: www.uspreventiveservicestaskforce.org. Input will be accepted through March 5, 2018, at www.uspreventiveservicestaskforce.org/tfcomment.htm. – by Janel Miller

Disclosure: Tseng reports no relevant financial disclosures.

Chien Wen-Tseng
Chien-Wen Tseng

The U.S. Preventive Services Task Force has issued a draft recommendation affirming its 2009 decision that all women who are pregnant should be screened for syphilis.

The “A” grade is only the 16th time out of 98 total recommendations that the USPSTF has issued this particular grade for a specific preventive service.

According to the USPSTF, despite many groups, including AAFP, echoing similar screening recommendations and many states mandating screening for syphilis infection at some point during gestation, incidence rates of primary and secondary syphilis infection in women and congenital syphilis in their offspring are rising.

Chien-Wen Tseng, MD, MPH, MSEE, of the department of family medicine and community health at the University of Hawaii and a USPSTF member, told Healio Family Medicine about the two-way conversation that primary care physicians and patients can have regarding this draft recommendation.

“[PCPs] should talk to all their pregnant patients about the importance of early screening for syphilis as part of routine prenatal care to keep women and their babies healthy. Women may have syphilis and not know it because early syphilis may cause no or few symptoms. Screening involves a simple blood test and treatment is with a common antibiotic,” she said. “Any woman who is concerned that she may have syphilis, or that she is at risk for passing syphilis to her baby at any time during or after her pregnancy, should talk about this with her doctor.”

Tseng said passing syphilis to fetuses during pregnancy could lead to “disastrous consequences” such as miscarriage, premature birth, the baby’s death after birth or severe birth defects.

Some research gaps still exist despite the “A” recommendation, she added.

“Additional research on … studies that compare different screening methods; identify the most effective times during pregnancy to provide repeat screenings and which higher risk populations should be rescreened; and assess the effectiveness and safety of treatment options aside from penicillin … would be worthwhile,” Tseng said.

The USPSTF’s draft statement and evidence review has been posted for public comment on the USPSTF website: www.uspreventiveservicestaskforce.org. Input will be accepted through March 5, 2018, at www.uspreventiveservicestaskforce.org/tfcomment.htm. – by Janel Miller

Disclosure: Tseng reports no relevant financial disclosures.