308 Significant racial/ethnic and sociodemographic disparities in syphilis among US pregnant women

Abstract

In recent years, there has been an increase in the prevalence of syphilis among pregnant women in the United States (US). We aimed to explore potential racial/ethnic and sociodemographic disparities in the prevalence of syphilis in US pregnancies. We conducted a retrospective analysis of the Centers for Disease Control’s Natality Live Birth database (2016-2018). The prevalence of syphilis was compared among gravidas of different racial/ethnic groups using Pearson’s chi-square test with Bonferroni adjustment. Logistic regression explored the association between syphilis and maternal race/ethnicity, age, education level, type of medical insurance, no or late (≥2nd trimester) prenatal care, total number of prenatal care visits and smoking during pregnancy. Results were displayed as adjusted odds ratios (aOR) and 95% confidence intervals (CI), and statistical significance was set as p-value < 0.05. The cohort included 9,917 live births to women with syphilis during pregnancy (0.10% of the total 10,199,489). Non-Hispanic Blacks had the highest prevalence of syphilis, followed by Hispanics (p<0.001) (Figure). Of the sociodemographic parameters, non-Hispanic Black race and education level less than high school graduation were associated with the highest risk for syphilis in pregnancy (aOR 4.82, 95% CI 4.57-5.08, and OR 4.15, 95% CI 3.59-4.79, respectively). Additional significant risk factors included education level of high school graduation, Medicaid insurance, smoking during pregnancy, maternal age ≥ 40, Hispanic ethnicity, and no prenatal care (Table). We document significant racial/ethnic and sociodemographic disparities in the risk of syphilis in US pregnancies. Most prominently, black race and low education level among other sociodemographic factors were associated with a substantially increased risk for syphilis in pregnancy. These findings suggest that public health initiatives to improve education, prevention, and access to screening and treatment of syphilis, should focus on these vulnerable high-risk populations.View Large Image Figure ViewerDownload Hi-res image Download (PPT)