Prenatal Syphilis Screening Among Medicaid Enrollees in 6 Southern States

Paul Lanier, School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: planier@unc.edu.
Susan Kennedy, AcademyHealth, Washington, District of Columbia.
Angela Snyder, Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia.
Jessica Smith, Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia.
Eric Napierala, Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia.
Jeffrey Talbert, Institute for Biomedical Informatics, College of Medicine, University of Kentucky, Louisville, Kentucky.
Lindsey Hammerslag, Institute for Biomedical Informatics, College of Medicine, University of Kentucky, Louisville, Kentucky.
Larry Humble, ULM College of Pharmacy, University of Louisiana Monroe, Monroe, Louisiana.
Eddy Myers, ULM College of Pharmacy, University of Louisiana Monroe, Monroe, Louisiana.
Anna Austin, School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Thomas Blount, School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Shannon Dowler, Division of Health Benefits, North Carolina Department of Health and Human Services, Raleigh, North Carolina.
Victoria Mobley, Division of Health Benefits, North Carolina Department of Health and Human Services, Raleigh, North Carolina.
Ana Lòpez-De Fede, Institute for Families in Society, University of South Carolina, Columbia, South Carolina.
Hoa Nguyen, Institute for Families in Society, University of South Carolina, Columbia, South Carolina.
Jean Bruce, Division of Pharmacoepidemiology, Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Carlos G. Grijalva, Division of Pharmacoepidemiology, Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Sunita Krishnan, AcademyHealth, Washington, District of Columbia.
Caitlin Otter, AcademyHealth, Washington, District of Columbia.
Katie Horton, Department of Health Policy, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
Naomi Seiler, Department of Health Policy, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
John Majors, Alabama Medicaid Agency, Montgomery, Alabama.
William S. Pearson, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

Document Type

Journal Article

Publication Date

1-5-2022

Journal

American journal of preventive medicine

DOI

10.1016/j.amepre.2021.11.011

Abstract

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.

Department

Health Policy and Management

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