State laws regarding prenatal syphilis screening in the United States.
OBJECTIVE
The purpose of this study was to assess the frequency and pattern of state laws or regulations regarding prenatal syphilis serologic screening in the United States in 2001.


METHODS
We surveyed the United States for existing laws and regulations regarding serologic screening for syphilis during pregnancy. Testing was compared with 2000 state rates of syphilis in women and newborn infants, with states that had syphilis high morbidity areas, and with national 2000 and 2010 objectives for rates of syphilis.


RESULTS
Forty-six of the 50 states (90%) and the District of Columbia have laws regarding antenatal syphilis screening. Thirty-four of the 46 statutes (76%) mandate one prenatal test, usually at the first prenatal visit or early in pregnancy. Twelve laws (26%) include third-trimester testing for all or high-risk women. The presence of high morbidity areas, incidence of early syphilis in women, and rates of congenital syphilis are associated with increasing frequency of legislated antepartum screening.


CONCLUSIONS
Only 90% of states have statutes that require antepartum syphilis screening, and there is variation in the content of the statutes about the number and timing of tests. States with a heavy burden of infectious syphilis in women tend to require more prenatal testing.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, LBJ General Hospital, 77026, USA. Lisa.M.Hollier@uth.tmc.edu
Lisa M
LM
Hollier
James
J
Hill
Jeanne S
JS
Sheffield
George D
GD
Wendel
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007878:Legislation as Topic; D011247:Pregnancy; D011296:Prenatal Diagnosis; D013587:Syphilis / Q000453:epidemiology; D013588:Syphilis Serodiagnosis; D014481:United States / Q000453:epidemiology