title: Examination of a prenatal syphilis screening program, Alberta, Canada: 2010-2011.
abstract: OBJECTIVE
  In 2009, due to increasing congenital syphilis rates, prenatal syphilis tests (PST) at both mid-gestation and delivery were added to first trimester prenatal screening in the province of Alberta. We sought to determine the proportion of mothers who had all three recommended PSTs during this period and to identify factors associated with incomplete PST.
  
  
  METHODS
  A cohort of all pregnancies resulting in a live or stillborn infant in Alberta for 2010 and 2011 was developed from Vital Statistics and linked with prenatal screening data to determine the number and timing of PSTs for pregnant women. The proportion of women who had PSTs at the three recommended time points in pregnancy and associated correlates were identified using basic statistics and logistic regressions.
  
  
  RESULTS
  Of 99,609 pregnancies, 20.7% had all three PSTs at the recommended time points. Overall, 98.5% (98,162) had at least one PST, 1.5% only had PST at delivery and 1.5% had no PST performed. Independent risk factors for not having the three recommended PSTs included First Nations status (adjusted odds ratio [AOR]: 1.78 [95% CI: 1.62-1.96]), rural remote residence (AOR 3.61 [95% CI: 3.10-4.20]) and sole use of a midwife for prenatal care (AOR 13.70 [95% CI: 9.20-20.39]).
  
  
  CONCLUSIONS
  Nearly all pregnant women in Alberta received a PST at least once during their pregnancy, however far fewer received PSTs at the recommended time points. Interventions that target those who are less likely to be prenatally screened may help to ensure that pregnant women get early and appropriate care for syphilis during pregnancy.
authors.affiliation: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON. splitt@ualberta.ca.
authors.forename: Sabrina S
authors.initials: SS
authors.lastname: Plitt
authors.forename: Mariam
authors.initials: M
authors.lastname: Osman
authors.forename: Vanita
authors.initials: V
authors.lastname: Sahni
authors.forename: Bonita E
authors.initials: BE
authors.lastname: Lee
authors.forename: Carmen
authors.initials: C
authors.lastname: Charlton
authors.forename: Kimberley
authors.initials: K
authors.lastname: Simmonds
mesh_terms: D000328:Adult; D000416:Alberta; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012307:Risk Factors; D013587:Syphilis / Q000175:diagnosis*; D055815:Young Adult