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State Requirements for Prenatal Syphilis Screening in the United States, 2016

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Abstract

Objectives This study assesses U.S. state laws related to prenatal syphilis screening, including whether these laws align with CDC screening recommendations and include legal penalties for failing to screen. Methods Statutes and regulations regarding syphilis screening during pregnancy and at delivery effective in 2016 were examined for all 50 U.S. states and the District of Columbia (DC). Targeted search terms were used to identify laws in legal research databases. The timing of the screening mandates for each state law was coded for: (1) first visit, (2) third trimester, and (3) delivery. Descriptive statistics were calculated to examine the number of states with each type of requirement and whether requirements adhered to the CDC STD treatment guidelines. Results Only six states (11.8%) do not require prenatal syphilis screening. Of states with screening requirements (n = 45), the majority (84.3%) require testing at first prenatal visit or soon after. 17 states (33.3%) require screening during the third trimester with five requiring screening only if the patient is considered at high risk. 8 (15.7%) states require screening at delivery with five requiring testing only if the woman is at high risk. 14 (27.5%) states include punishments for failing to screen (civil penalties, criminal penalties and license revocation). Conclusions for Practice Most states had prenatal syphilis screening requirements; a minority corresponded to or extended CDC recommendations. States vary in when they require testing, who must be tested, and whether a failure to screen could result in a punishment for the provider.

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Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

This research was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC.

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Authors and Affiliations

  1. Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-02, Atlanta, GA, 30329-4027, USA

    Hardin P. Warren, Ryan Cramer, Sarah Kidd & Jami S. Leichliter

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  1. Hardin P. Warren
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  2. Ryan Cramer
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  3. Sarah Kidd
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  4. Jami S. Leichliter
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Correspondence to Ryan Cramer.

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The authors report no conflict of interest.

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Warren, H.P., Cramer, R., Kidd, S. et al. State Requirements for Prenatal Syphilis Screening in the United States, 2016. Matern Child Health J 22, 1227–1232 (2018). https://doi.org/10.1007/s10995-018-2592-0

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  • DOI: https://doi.org/10.1007/s10995-018-2592-0

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