{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:14:32Z","timestamp":1779196472879,"version":"3.51.4"},"reference-count":21,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,9,8]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify factors associated with inadequate or no syphilis treatment during pregnancy within an urban low-income safety-net hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective case control study of pregnant patients diagnosed with new syphilis infections between July 2019 and July 2024 to determine predictors of inadequate or no treatment. Treatment was considered adequate if patients received appropriate doses of intramuscular benzathine penicillin G consistent with syphilis stage. Fisher\u2019s exact test and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test were performed for categorical variables. After adjusting for age, body mass index, substance use during pregnancy, diagnosis before 24 weeks and syphilis stage, a multivariable logistic regression was used to calculate adjusted OR (aOR) with a 95% CI. Statistical significance tests relied on a two-sided \u03b1=0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 150 pregnant patients were diagnosed with syphilis; approximately 36.7% (n=55) received no or inadequate treatment. Late latent and unknown syphilis stages were predictors of inadequate syphilis treatment with the following respective aORs: aOR 4.52; 95% CI 1.10 to 18.6 and aOR 7.64; 95% CI 2.19 to 26.7. Infection diagnosis before 24 weeks\u2019 gestation (aOR 0.18; 95% CI 0.07 to 0.42) was a significant predictor of adequate treatment. Partner treatment status was unknown or none for 89.3% of patients (n=134).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients diagnosed with syphilis stages that require multi-dose treatments are at higher risk for inadequate treatment. Efforts to promote early diagnosis and staging in this community are needed. Widespread neglect of partner treatment may be contributing to this epidemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056601","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T17:20:28Z","timestamp":1758993628000},"page":"210-216","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Stop the spread: predictors of inadequate syphilis treatment in pregnancy"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-7568","authenticated-orcid":false,"given":"Emma Jane","family":"Swayze","sequence":"first","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Liske","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"DeCarr","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Wendel","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa","family":"Swailes","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"VanDillen","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Nakahara","sequence":"additional","affiliation":[{"name":"OB-GYN, UTHSC College of Medicine, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,27]]},"reference":[{"key":"2026051905450682000_102.4.210.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.107623"},{"key":"2026051905450682000_102.4.210.2","first-page":"22","article-title":"Syphilis in Pregnancy","volume":"66","author":"Adhikari","year":"2021","journal-title":"Contemporary OB\/GYN Journal"},{"key":"2026051905450682000_102.4.210.3","doi-asserted-by":"crossref","unstructured":"Wicher V , Wicher K . Pathogenesis of Maternal-Fetal Syphilis Revisited, Clinical Infectious Diseases. Clin Infect Dis 2001;354\u201363. doi:10.1086\/321904","DOI":"10.1086\/321904"},{"key":"2026051905450682000_102.4.210.4","unstructured":"Centers for Disease Control and Prevention . Vital signs: syphilis in babies reflects health system failures. 2023. Available: https:\/\/stacks.cdc.gov\/view\/cdc\/135000"},{"key":"2026051905450682000_102.4.210.5","unstructured":"American College of Obstetricians and Gynecologists . Screening for syphilis in pregnancy: practice advisory. 2024. Available: https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-advisory\/articles\/2024\/04\/screening-for-syphilis-in-pregnancy"},{"key":"2026051905450682000_102.4.210.6","unstructured":"Kind AJH . Neighborhood atlas\u00ae. Neighborhood Atlas - Home. 2018. Available: https:\/\/www.neighborhoodatlas.medicine.wisc.edu\/"},{"key":"2026051905450682000_102.4.210.7","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/AOG.0000000000005586","article-title":"Syphilis Treatment Among People Who Are Pregnant in Six U.S. States, 2018\u20132021","volume":"143","author":"Tannis","year":"2024","journal-title":"Obstet Gynecol"},{"key":"2026051905450682000_102.4.210.8","first-page":"178","article-title":"Missed opportunities for prevention of congenital syphilis. Oportunidades perdidas en la prevenci\u00f3n de la s\u00edfilis cong\u00e9nita en M\u00e9xico","volume":"160","author":"Hern\u00e1ndez-Mu\u00f1oz","year":"2024","journal-title":"Gac Med Mex"},{"key":"2026051905450682000_102.4.210.9","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1522698","article-title":"The rise of congenital syphilis in Canada: threats and opportunities","volume":"12","author":"Tetteh","year":"2024","journal-title":"Front Public Health"},{"key":"2026051905450682000_102.4.210.10","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000534"},{"key":"2026051905450682000_102.4.210.11","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s10995-007-0247-7","article-title":"Racial and ethnic disparities in prenatal syphilis screening among women with Medicaid-covered deliveries in Florida","volume":"12","author":"Fowler","year":"2008","journal-title":"Matern Child Health J"},{"key":"2026051905450682000_102.4.210.12","unstructured":"Health Resources and Services Administration, Centers for Disease Control and Prevention . BPHC bulletin: joint HRSA-CDC letter on congenital syphilis. U.S. Department of Health and Human Services; 2024. Available: http:\/\/content.govdelivery.com\/accounts\/USHHSHRSA\/bulletins\/394206d"},{"key":"2026051905450682000_102.4.210.13","unstructured":"Louisiana Department of Health . LDH launches congenital syphilis prevention pilot to increae screening opportunities during pregnancy. State of Louisiana; 2024. Available: http:\/\/ldh.la.gov\/news\/CS-pilot"},{"key":"2026051905450682000_102.4.210.14","doi-asserted-by":"crossref","DOI":"10.1007\/s11904-025-00725-4","article-title":"Expanding Horizons in Syphilis Treatment: Challenges, Advances, and Opportunities for Alternative Antibiotics","volume":"22","author":"Villarreal","year":"2025","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2026051905450682000_102.4.210.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002473","article-title":"Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews","volume":"14","author":"Nurse-Findlay","year":"2017","journal-title":"PLoS Med"},{"key":"2026051905450682000_102.4.210.16","article-title":"Factors associated with inadequate treatment of syphilis during pregnancy: an integrative review","volume":"75","author":"Torres","year":"2022","journal-title":"Rev Bras Enferm"},{"key":"2026051905450682000_102.4.210.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12939-023-01866-x","article-title":"Factors influencing treatment status of syphilis among pregnant women: a retrospective cohort study in Guangzhou, China","volume":"22","author":"Liu","year":"2023","journal-title":"Int J Equity Health"},{"key":"2026051905450682000_102.4.210.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-020-03314-y","article-title":"Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China","volume":"20","author":"Wan","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026051905450682000_102.4.210.19","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-022-07100-3","article-title":"Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California","volume":"22","author":"Park","year":"2022","journal-title":"BMC Infect Dis"},{"key":"2026051905450682000_102.4.210.20","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001277"},{"key":"2026051905450682000_102.4.210.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2015.03.005"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:46:30Z","timestamp":1779194790000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,27]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/sextrans-2025-056601"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056601","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,27]]}}}