{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:17:30Z","timestamp":1788182250204,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The rate of congenital syphilis increased 498% in Michigan during 2017\u20132023. Congenital syphilis can be averted if a pregnant woman is screened and treatment initiated \u226530 days before delivery. To strengthen prevention strategies in Michigan, legislation was passed in December 2018 requiring universal prenatal syphilis screening in the first and third trimesters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed de\u2010identified health claims data from women enrolled in Michigan Medicaid who delivered an infant during 2017\u20132023. Timing of syphilis screening was estimated by subtracting the date of screening from the date of delivery. Percentage of pregnant women (1) ever screened (280\u20130 days preceding delivery); (2) screened during approximately the first or second trimesters (280\u201394 days preceding delivery) and in the early third trimester (93\u201330 days preceding delivery), jointly and separately; and (3) screened\u00a0&lt;30 days preceding delivery were calculated and compared pre\u2010legislation (2017) versus 5 years post\u2010legislation (2023). Absolute percentage changes were evaluated by demographic characteristics, including residence in counties with elevated syphilis among reproductive\u2010aged women (&gt;\u00a04.6 cases per 100,000 people); changes\u00a0&lt;10% were considered stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the 7\u2010year study period, 211,289 deliveries were evaluated; approximately half the sample were Non\u2010Hispanic White, half were younger than 27 years (median age), and three\u2010quarters resided in counties with elevated syphilis rates. Screening for syphilis at least once during pregnancy was common (average, 92.0%), as was screening during the first or second trimester (82.3%); screening only\u00a0&lt;30 days preceding delivery was infrequent (8.9%); percentages were stable pre\u2010 and post\u2010legislation (\u22121.8%, \u22124.0%, and +1.8%, respectively). Screening in the early third trimester increased post\u2010legislation (37.1%\u201353.7%), as did screening in the first or second trimester and repeated in the early third trimester (30.1%\u201345.0%). Screening increases were less pronounced in counties with higher syphilis burden compared with lower burden areas. Findings were similar across age and race\/ethnicity subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Repeat syphilis screenings have increased following legislation requiring universal first and third trimester testing. Strategies to raise awareness of the necessity and value of repeat prenatal syphilis testing, especially in the early third trimester, are important to strengthen congenital syphilis prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70219","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:56:51Z","timestamp":1769000211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modest improvement in universal prenatal syphilis screening 5 years after legislation enacted"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6407-7280","authenticated-orcid":false,"given":"Jill C.","family":"Diesel","sequence":"first","affiliation":[{"name":"Division of STD Prevention National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Michigan Department of Health and Human Services  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Macomber","sequence":"additional","affiliation":[{"name":"Michigan Department of Health and Human Services  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2018.02.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7004a1"},{"key":"e_1_2_11_4_1","volume-title":"StatPearls","author":"Leslie S. W.","year":"2025"},{"key":"e_1_2_11_5_1","volume-title":"Sexually Transmitted Infections Surveillance 2023","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_11_6_1","volume-title":"Sexually Transmitted Disease Surveillance 2021","author":"Centers for Disease Control and Prevention","year":"2023"},{"key":"e_1_2_11_7_1","unstructured":"Centers for Disease Control and Prevention (CDC).County\u2010Level Data Table of Primary and Secondary Syphilis Rates Among Women Aged 15\u201344 2023. Accessed February 28 2025. Available at:https:\/\/www.cdc.gov\/sti\u2010statistics\/county\u2010level\u2010syphilis\u2010data\/index.html."},{"key":"e_1_2_11_8_1","unstructured":"STI Annual Diagnoses and Trends\u20102023.Data as of July 25 2024. HIV & STIs in Michigan. Bureau of HIV and STI Programs. Michigan Department of Health and Human Services. Accessed May 12 2025. Available at:https:\/\/www.michigan.gov\/mdhhs\/\u2010\/media\/Project\/Websites\/mdhhs\/Keeping\u2010Michigan\u2010Healthy\/HIVSTI\/Data\u2010and\u2010Statistics\/2023\/2023\u2010STIs\u2010and\u2010Trends\u2010in\u2010Michigan\u2010Overview.pdf?rev=b526a2cb64f7406a9d42c1ca3314d1e6&hash=1B0BF090B55121AD0870E79D1963177F."},{"key":"e_1_2_11_9_1","unstructured":"Michigan Legislature.MCL\u2010Section 333.5123 Initial Examination or Third Trimester of Pregnant Woman or Woman Recently Delivering Infant; Test Specimens Required; Exceptions; Record; Availability of Test Results and Records. Accessed March 12 2025. Available at:https:\/\/www.legislature.mi.gov\/Laws\/MCL?objectName=mcl\u2010333\u20105123."},{"key":"e_1_2_11_10_1","unstructured":"Michigan Department of Health and Human Services (MDHHS) Perinatal Human Immunodeficiency Virus (HIV) Hepatitis B Hepatitis C and Syphilis Testing and Reporting Guidelines. Accessed November 19 2024. Available at:https:\/\/www.michigan.gov\/\u2010\/media\/Project\/Websites\/mdhhs\/Keeping\u2010Michigan\u2010Healthy\/HIVSTI\/Perinatal\u2010HIV\u2010STIs\/Guidelines_for_Perinatal_Testing_and_Reporting.pdf?rev=4d2b0fcfa6fe4066b0628e3dc2b56638#:~:text=28%2D%2032%20weeks%2C%20regardless%20of screening%20tests%20must%20be%20confirmed."},{"key":"e_1_2_11_11_1","unstructured":"CDC (Centers for Disease Control and Prevention).2015.Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. Accessed September 19 2025. Available at:https:\/\/www.cdc.gov\/std\/treatment\u2010guidelines\/screening\u2010recommendations.htm."},{"key":"e_1_2_11_12_1","unstructured":"Kaiser Family Foundation (KFF).Fact Sheet: Medicaid Expansion in Michigan. Accessed Friday January 31 2025. 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Available at:https:\/\/www.kff.org\/medicaid\/state\u2010indicator\/births\u2010financed\u2010by\u2010medicaid\/?activeTab=grap&currentTimeframe=0&startTimeframe=7&selectedDistributions=percent\u2010of\u2010births\u2010financed\u2010by\u2010medicaid&sortModel=%7B%22colId%22:%22Location%22 %22sort%22:%22asc%22%7D."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.02.019"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000945"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.11.011"},{"issue":"45","key":"e_1_2_11_17_1","first-page":"1013","article-title":"HIV Testing Among Pregnant Women\u2010United States and Canada, 1998\u20132001","volume":"51","author":"Roome A.","year":"2002","journal-title":"MMWR"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100875"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2011.05.002"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001311"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7246e1"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/whr.2023.0072"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/01939459211043941"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7420a3"},{"key":"e_1_2_11_25_1","unstructured":"American College of Obstetricians and Gynecologists.Practice Advisory: Screening for Syphilis in Pregnancy. 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