{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:28:51Z","timestamp":1767853731390,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81741047"],"award-info":[{"award-number":["81741047"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2016YFC1000307"],"award-info":[{"award-number":["2016YFC1000307"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The antenatal screening strategy remains inadequate for eliminating congenital syphilis. To further eliminate maternal fetal transmission, preconception syphilis screening is considered an option. In this study, we investigated syphilis seropositivity and intra\u2010couple discordance among married couples planning a pregnancy in China to provide essential baseline evidence for preconception syphilis screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National preconception registered data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Married Chinese couples planning conception within 6\u2009months between 2013 and 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Syphilis was screened using rapid plasma reagin (RPR); infection self\u2010reporting and sociodemographic characteristics were collected through questionnaires and medical records, respectively. <jats:sc>r<\/jats:sc>\u20093.2.2 and <jats:sc>arcgis<\/jats:sc>\u200910.2 were used for statistical analyses and geographic mapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>RPR seropositivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 31\u2009955\u2009041 couples, 29\u2009737\u2009172 (93.06%) had complete RPR results for both spouses; of those, 0.62% (186\u2009100) were seropositive, with dramatic intra\u2010couple discordance, with 0.33% positivity in wives, 0.24% positivity in husbands and 0.05% positivity in both spouses. Across time, both seropositivity and intra\u2010couple discordance remained stable. Seropositivity in different regions varied significantly, with provincial rates ranging geographically from Tibet (0.8%) to Hebei (0.2%) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Economic level was an independent factor for this regional variation, with seropositivity increasing as gross domestic product income decreased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intra\u2010couple discordance in seropositivity for syphilis is notable among couples, with a considerable rate of pre\u2010existing syphilis before pregnancy. Thus, screening both spouses during integrated preconception health care is recommended for further eliminating maternal\u2013fetal transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Intra\u2010couple discordance in seropositivity for syphilis is notable among couples, with a considerable rate of pre\u2010existing syphilis before pregnancy. Screening both spouses during integrated preconception health care is recommended to further eliminate maternal\u2013fetal transmission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16923","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T08:02:16Z","timestamp":1631865736000},"page":"313-321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intra\u2010couple discordance in preconception syphilis screening for both spouses: a national and population\u2010based survey in China, 2013\u20132018"],"prefix":"10.1111","volume":"129","author":[{"given":"Q","family":"Zhou","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology Hospital of Fudan University Shanghai China"},{"name":"Shanghai Key Laboratory of Female Reproductive Endocrine\u2010Related Diseases Shanghai China"},{"name":"Women\u2019s Health and Perinatology Research Group Department of Clinical Medicine UiT\u2010The Arctic University of Norway Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Yang","sequence":"additional","affiliation":[{"name":"National Research Institute for Family Planning Beijing China"},{"name":"National Human Genetic Resources Center Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Wang","sequence":"additional","affiliation":[{"name":"National Research Institute for Family Planning Beijing China"},{"name":"Graduate School of Peking Union Medical College Beijing China"},{"name":"School of Public Health Institute for Epidemiology and Statistics Lanzhou University Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X","family":"Chen","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Hospital of Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q","family":"Xu","sequence":"additional","affiliation":[{"name":"National Research Institute for Family Planning Beijing China"},{"name":"Graduate School of Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health National Health and Family Planning Commission of the People\u2019s Republic of China Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health National Health and Family Planning Commission of the People\u2019s Republic of China Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health National Health and Family Planning Commission of the People\u2019s Republic of China Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health National Health and Family Planning Commission of the People\u2019s Republic of China Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health National Health and Family Planning Commission of the People\u2019s Republic of China Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Peng","sequence":"additional","affiliation":[{"name":"National Research Institute for Family Planning Beijing China"},{"name":"National Human Genetic Resources Center Beijing 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