title: Syphilis screening in pregnancy in the United Kingdom, 2010-2011: a national surveillance study.
abstract: To evaluate the national antenatal syphilis screening programme and provide evidence for improving screening and management strategies.
  
  
  
  National population-based surveillance.
  
  
  
  United Kingdom (UK).
  
  
  
  All pregnant women screening positive for syphilis, 2010-2011.
  
  
  
  Demographic, laboratory and treatment details for each pregnancy were collected from UK antenatal units (~210), along with follow-up information on all infants born to women requiring syphilis treatment in pregnancy.
  
  
  
  Proportion of women with newly or previously diagnosed syphilis among those with positive screening tests in pregnancy; proportion requiring treatment.
  
  
  
  Overall, 77% (1425/1840) of reported pregnancies were confirmed syphilis screen-positive. Of these, 71% (1010/1425) were in women with previously diagnosed syphilis (155 requiring treatment), 26% (374/1425) with newly diagnosed syphilis (all requiring treatment) and 3% (41/1425) required treatment but the reason for treatment was unclear. Thus 40% (570/1425) required treatment overall; of these, 96% (516/537) were treated (missing data: 33/570), although for 18% (83/456), this was not until the third trimester (missing data: 60/537). Follow up of infants born to treated women was poor, with at least a third not followed. Six infants were diagnosed with congenital syphilis; two mothers were untreated, three had delayed treatment and one had incomplete treatment (first trimester).
  
  
  
  Over 2 years, among pregnant women with confirmed positive syphilis screening results in the UK, a quarter had newly diagnosed infections and 40% required treatment. Despite high uptake of treatment, antenatal syphilis management could be improved by earlier detection, earlier treatment, and stronger links between healthcare teams.
  
  
  
  25% of pregnant women screening positive for syphilis in the UK were newly diagnosed and 40% needed treatment.
authors.affiliation: Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Townsend
authors.affiliation: Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Francis
authors.affiliation: Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
authors.forename: C S
authors.initials: CS
authors.lastname: Peckham
authors.affiliation: Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Tookey
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D013590:Syphilis, Congenital / Q000175:diagnosis / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
keywords: Congenital infection; epidemiology; pregnancy; surveillance; syphilis