Reports of infants born with congenital syphilis have increased in the United States every year since 2012. Prevention depends on high performing surveillance systems and compliance with the U.S. Centers for Disease Control and Prevention (CDC) recommendations to perform syphilis testing early in pregnancy, in the third trimester and at delivery if a woman is at high risk, and following a stillbirth delivery. These guidelines exist, because untreated syphilis is associated with adverse fetal outcomes including central nervous system infection and death. Surveillance of congenital syphilis and stillbirth is challenging because available data sources are limited. Assessment of compliance with testing guidelines is particularly challenging, since public health agencies often lack access to comprehensive cohorts of tested individuals as most public health laws only require reporting of positive disease case information.
Objective:
To measure stillbirth delivery rates and syphilis screening rates among women with a stillbirth delivery using electronic health record data available in a health information exchange.