Document Detail


Screening for syphilis infection in pregnant women: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement.
MedLine Citation:
PMID:  19451578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 2004, the U.S. Preventive Services Task Force strongly recommended that clinicians screen all pregnant women for syphilis infection. PURPOSE: To update the evidence on screening pregnant women for syphilis infection. DATA SOURCES: MEDLINE searches from 1 January 2003 through 31 July 2008, recent systematic reviews, reference lists of retrieved articles, and expert suggestions. STUDY SELECTION: English-language studies were selected to answer the following 2 questions: Does screening for syphilis in pregnancy reduce the prevalence of congenital syphilis in neonates? Are there harms of screening for syphilis or harms of treatment with penicillin in pregnancy to women or neonates? Randomized, controlled trials; meta-analyses; systematic reviews; cohort studies; and ecologic studies were selected for the potential benefits question. Randomized, controlled trials; meta-analyses; systematic reviews; cohort studies; case-control studies; and large case series were selected for the potential harms question. DATA EXTRACTION: Information on the study design, selection criteria, demographic characteristics, and clinical outcomes was extracted from each study. DATA SYNTHESIS: One study on benefits evaluated the effect before and after the implementation of a universal syphilis screening program for pregnant women and found reductions in rates of congenital syphilis. Two studies on screening accuracy for syphilis reported false-positive rates of less than 1%. One study that used a large insurance claims database reported an incidence of anaphylaxis after oral penicillin of 0.1 per 10,000 dispensings. In a study from Hungary, oral penicillin in pregnancy was not associated with orofacial clefts. LIMITATIONS: This was a targeted literature search and could have missed small studies on the benefits and harms of screening for syphilis in pregnancy. We did not review evidence on interventions to improve rates of prenatal screening. CONCLUSION: New evidence from a study of universal screening supports previous evidence on the effectiveness of screening for syphilis in pregnancy to prevent congenital syphilis. Harms include testing and follow-up for false-positive test results and adverse effects from penicillin treatment.
Authors:
Tracy Wolff; Erica Shelton; Cecili Sessions; Therese Miller
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of internal medicine     Volume:  150     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-19     Completed Date:  2009-06-03     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  710-6     Citation Subset:  AIM; IM    
Affiliation:
U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / adverse effects,  therapeutic use
Evidence-Based Medicine
False Positive Reactions
Female
Humans
Infant, Newborn
Mass Screening* / adverse effects
Penicillin G Benzathine / adverse effects,  therapeutic use
Pregnancy
Pregnancy Complications, Infectious / diagnosis*,  drug therapy*
Risk Assessment
Syphilis / diagnosis*,  drug therapy*
Syphilis, Congenital / prevention & control*
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1538-09-6/Penicillin G Benzathine
Comments/Corrections
Summary for patients in:
Ann Intern Med. 2009 May 19;150(10):I-40   [PMID:  19451558 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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