Prenatal Syphilis Screening Among Medicaid Enrollees in 6 Southern States

Paul Lanier, Susan Kennedy, Angela Snyder, Jessica Smith, Eric Napierala, Jeffrey Talbert, Lindsey Hammerslag, Larry Humble, Eddy Myers, Anna Austin, Thomas Blount, Shannon Dowler, Victoria Mobley, Ana Lòpez De Fede, Hoa Nguyen, Jean Bruce, Carlos G. Grijalva, Sunita Krishnan, Caitlin Otter, Katie HortonNaomi Seiler, John Majors, William S. Pearson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction: The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South. Methods: A total of 6 state–university research partnerships in the U.S. South developed a distributed research network to analyze Medicaid claims data using a common analytic approach for enrollees with delivery in fiscal years 2017–2018 and 2018–2019 (combined N=504,943). In 2020–2021, each state calculated the percentage of enrollees with delivery with a syphilis screen test during the first trimester, third trimester, and at any point during pregnancy. Percentages for those with first-trimester enrollment were compared with the percentages of those who enrolled in Medicaid later in pregnancy. Results: Prenatal syphilis screening during pregnancy ranged from 56% to 91%. Screening was higher among those enrolled in Medicaid during the first trimester than in those enrolled later in pregnancy. Conclusions: Despite state laws requiring syphilis screening during pregnancy, screening was much lower than 100%, and states varied in syphilis screening rates among Medicaid enrollees. Findings indicate that access to Medicaid in the first trimester is associated with higher rates of syphilis screening and that efforts to improve access to screening in practice settings are needed.

Original languageEnglish
Pages (from-to)770-776
Number of pages7
JournalAmerican Journal of Preventive Medicine
Issue number5
StatePublished - May 2022

Bibliographical note

Publisher Copyright:
© 2021 American Journal of Preventive Medicine

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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