Syphilis screening in pregnancy in the United Kingdom, 2010–2011: a national surveillance study

Objective To evaluate the national antenatal syphilis screening programme and provide evidence for improving screening and management strategies. Design National population‐based surveillance. Setting United Kingdom (UK). Population All pregnant women screening positive for syphilis, 2010–2011. Methods Demographic, laboratory and treatment details for each pregnancy were collected from UK antenatal units (~210), along with follow‐up information on all infants born to women requiring syphilis treatment in pregnancy. Main outcome measures Proportion of women with newly or previously diagnosed syphilis among those with positive screening tests in pregnancy; proportion requiring treatment. Results Overall, 77% (1425/1840) of reported pregnancies were confirmed syphilis screen‐positive. Of these, 71% (1010/1425) were in women with previously diagnosed syphilis (155 requiring treatment), 26% (374/1425) with newly diagnosed syphilis (all requiring treatment) and 3% (41/1425) required treatment but the reason for treatment was unclear. Thus 40% (570/1425) required treatment overall; of these, 96% (516/537) were treated (missing data: 33/570), although for 18% (83/456), this was not until the third trimester (missing data: 60/537). Follow up of infants born to treated women was poor, with at least a third not followed. Six infants were diagnosed with congenital syphilis; two mothers were untreated, three had delayed treatment and one had incomplete treatment (first trimester). Conclusion Over 2 years, among pregnant women with confirmed positive syphilis screening results in the UK, a quarter had newly diagnosed infections and 40% required treatment. Despite high uptake of treatment, antenatal syphilis management could be improved by earlier detection, earlier treatment, and stronger links between healthcare teams. Tweetable 25% of pregnant women screening positive for syphilis in the UK were newly diagnosed and 40% needed treatment. Tweetable 25% of pregnant women screening positive for syphilis in the UK were newly diagnosed and 40% needed treatment.