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Outcomes After Positive Syphilis Screening.

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Title: Outcomes After Positive Syphilis Screening.
Authors: O'Connor, Nicola P., Burke, Patrick C., Worley, Sarah, Kadkhoda, Kamran, Goje, Oluwatosin, Foster, Charles B.
Source: Pediatrics. Sep2022, Vol. 150 Issue 3, p1-9. 12p.
Subjects: Diagnosis of syphilis, Mothers, Communicable diseases, Confidence intervals, Immunoglobulins, Syphilis, Congenital, hereditary, & infantile syphilis, Third trimester of pregnancy, Medical screening, Reinfection, Comparative studies, Pregnancy complications, Descriptive statistics, Symptoms, Diagnostic errors, Vertical transmission (Communicable diseases)
Abstract: BACKGROUND: Syphilis screening during pregnancy helps prevent congenital syphilis. The harms associated with false positive (FP) screens and whether screening leads to correct treatments has not been well determined. METHODS: The population included mothers and infants from 75 056 pregnancies. Using laboratory-based criteria we classified initial positive syphilis screens as FP or true positive (TP) and calculated false discovery rates. For mothers and infants we determined treatments, clinical characteristics, and syphilis classifications. RESULTS: There were 221 positive screens: 183 FP and 38 TP. The false discovery rate was 0.83 (95% confidence interval [CI], 0.78-0.88). False discovery rates were similar for traditional 0.83 [95% CI, 0.72-0.94] and reverse algorithms 0.83 (95% CI, 0.77-0.88), and for syphilis Immunoglobin (Ig) G 0.79 (95% CI, 0.71-0.86) and total 0.90 (95% CI, 0.82-0.97) assays. FP screens led to treatment in 2 women and 1 infant. Two high-risk women were not rescreened at delivery and were diagnosed after hospital discharge; 1 infant developed congenital syphilis. Among 15 TP women with new syphilis, the diagnosis was before the late third trimester in 14 (93%). In one-half of these women, there was concern for reinfection, treatment failure, inadequate treatment or follow-up care, or late treatment, and their infants did not achieve an optimal syphilis classification. CONCLUSIONS: Syphilis screening identifies maternal syphilis, but limitations include FP screens, which occasionally lead to unnecessary treatment, inconsistent risk-based rescreening, and among TP mothers failure to optimize care to prevent birth of infants at higher risk for congenital syphilis. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Outcomes After Positive Syphilis Screening.
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  Data: <searchLink fieldCode="AR" term="%22O'Connor%2C+Nicola+P%2E%22">O'Connor, Nicola P.</searchLink><br /><searchLink fieldCode="AR" term="%22Burke%2C+Patrick+C%2E%22">Burke, Patrick C.</searchLink><br /><searchLink fieldCode="AR" term="%22Worley%2C+Sarah%22">Worley, Sarah</searchLink><br /><searchLink fieldCode="AR" term="%22Kadkhoda%2C+Kamran%22">Kadkhoda, Kamran</searchLink><br /><searchLink fieldCode="AR" term="%22Goje%2C+Oluwatosin%22">Goje, Oluwatosin</searchLink><br /><searchLink fieldCode="AR" term="%22Foster%2C+Charles+B%2E%22">Foster, Charles B.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Sep2022, Vol. 150 Issue 3, p1-9. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Diagnosis+of+syphilis%22">Diagnosis of syphilis</searchLink><br /><searchLink fieldCode="DE" term="%22Mothers%22">Mothers</searchLink><br /><searchLink fieldCode="DE" term="%22Communicable+diseases%22">Communicable diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Immunoglobulins%22">Immunoglobulins</searchLink><br /><searchLink fieldCode="DE" term="%22Syphilis%22">Syphilis</searchLink><br /><searchLink fieldCode="DE" term="%22Congenital%2C+hereditary%2C+%26+infantile+syphilis%22">Congenital, hereditary, & infantile syphilis</searchLink><br /><searchLink fieldCode="DE" term="%22Third+trimester+of+pregnancy%22">Third trimester of pregnancy</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+screening%22">Medical screening</searchLink><br /><searchLink fieldCode="DE" term="%22Reinfection%22">Reinfection</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Pregnancy+complications%22">Pregnancy complications</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+errors%22">Diagnostic errors</searchLink><br /><searchLink fieldCode="DE" term="%22Vertical+transmission+%28Communicable+diseases%29%22">Vertical transmission (Communicable diseases)</searchLink>
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  Label: Abstract
  Group: Ab
  Data: BACKGROUND: Syphilis screening during pregnancy helps prevent congenital syphilis. The harms associated with false positive (FP) screens and whether screening leads to correct treatments has not been well determined. METHODS: The population included mothers and infants from 75 056 pregnancies. Using laboratory-based criteria we classified initial positive syphilis screens as FP or true positive (TP) and calculated false discovery rates. For mothers and infants we determined treatments, clinical characteristics, and syphilis classifications. RESULTS: There were 221 positive screens: 183 FP and 38 TP. The false discovery rate was 0.83 (95% confidence interval [CI], 0.78-0.88). False discovery rates were similar for traditional 0.83 [95% CI, 0.72-0.94] and reverse algorithms 0.83 (95% CI, 0.77-0.88), and for syphilis Immunoglobin (Ig) G 0.79 (95% CI, 0.71-0.86) and total 0.90 (95% CI, 0.82-0.97) assays. FP screens led to treatment in 2 women and 1 infant. Two high-risk women were not rescreened at delivery and were diagnosed after hospital discharge; 1 infant developed congenital syphilis. Among 15 TP women with new syphilis, the diagnosis was before the late third trimester in 14 (93%). In one-half of these women, there was concern for reinfection, treatment failure, inadequate treatment or follow-up care, or late treatment, and their infants did not achieve an optimal syphilis classification. CONCLUSIONS: Syphilis screening identifies maternal syphilis, but limitations include FP screens, which occasionally lead to unnecessary treatment, inconsistent risk-based rescreening, and among TP mothers failure to optimize care to prevent birth of infants at higher risk for congenital syphilis. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=164235057
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1542/peds.2022-056457
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 1
    Subjects:
      – SubjectFull: Diagnosis of syphilis
        Type: general
      – SubjectFull: Mothers
        Type: general
      – SubjectFull: Communicable diseases
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Immunoglobulins
        Type: general
      – SubjectFull: Syphilis
        Type: general
      – SubjectFull: Congenital, hereditary, & infantile syphilis
        Type: general
      – SubjectFull: Third trimester of pregnancy
        Type: general
      – SubjectFull: Medical screening
        Type: general
      – SubjectFull: Reinfection
        Type: general
      – SubjectFull: Comparative studies
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      – SubjectFull: Pregnancy complications
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Symptoms
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      – SubjectFull: Diagnostic errors
        Type: general
      – SubjectFull: Vertical transmission (Communicable diseases)
        Type: general
    Titles:
      – TitleFull: Outcomes After Positive Syphilis Screening.
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            NameFull: Kadkhoda, Kamran
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              Text: Sep2022
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              Y: 2022
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