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Examination of a prenatal syphilis screening program, Alberta, Canada: 2010–2011

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Abstract

OBJECTIVES: In 2009, due to increasing congenital syphilis rates, prenatal syphilis tests (PST) at both mid-gestation and delivery were added to first trimester prenatal screening in the province of Alberta. We sought to determine the proportion of mothers who had all three recommended PSTs during this period and to identify factors associated with incomplete PST.

METHODS: A cohort of all pregnancies resulting in a live or stillborn infant in Alberta for 2010 and 2011 was developed from Vital Statistics and linked with prenatal screening data to determine the number and timing of PSTs for pregnant women. The proportion of women who had PSTs at the three recommended time points in pregnancy and associated correlates were identified using basic statistics and logistic regressions.

RESULTS: Of 99,609 pregnancies, 20.7% had all three PSTs at the recommended time points. Overall, 98.5% (98,162) had at least one PST, 1.5% only had PST at delivery and 1.5% had no PST performed. Independent risk factors for not having the three recommended PSTs included First Nations status (adjusted odds ratio [AOR]: 1.78 [95% CI: 1.62–1.96]), rural remote residence (AOR 3.61 [95% CI: 3.10–4.20]) and sole use of a midwife for prenatal care (AOR 13.70 [95% CI: 9.20–20.39]).

CONCLUSIONS: Nearly all pregnant women in Alberta received a PST at least once during their pregnancy, however far fewer received PSTs at the recommended time points. Interventions that target those who are less likely to be prenatally screened may help to ensure that pregnant women get early and appropriate care for syphilis during pregnancy.

Résumé

OBJECTIFS : En 2009, la hausse des taux de syphilis congénitale a poussé la province de l’Alberta à ajouter aux dépistages systématiques du premier trimestre des tests prénatals pour la syphilis (TPS) au milieu de la grossesse et à l’accouchement. Nous avons cherché à déterminer la proportion des mères ayant subi les trois TPS recommandés durant la grossesse et l’accouchement et à cerner les facteurs associés aux TPS incomplets.

MÉTHODE : À l’aide des statistiques de l’état civil, nous avons créé une cohorte de toutes les grossesses ayant donné lieu à un enfant vivant ou mort-né en Alberta en 2010 et en 2011 et nous l’avons liée aux données de dépistage prénatal afin de déterminer le nombre et le moment des TPS administrés aux femmes enceintes. La proportion des femmes ayant subi des TPS aux trois points recommandés durant leur grossesse, et les corrélats associés, ont été déterminés à l’aide de statistiques élémentaires et de régressions logistiques.

RÉSULTATS : Sur 99 609 grossesses, 20,7 % de femmes avaient subi les trois TPS aux points recommandés dans le temps. Dans l’ensemble, 98,5 % des femmes enceintes (98 162) avaient subi au moins un TPS, 1,5 % n’avaient subi qu’un TPS à l’accouchement et 1,5 % n’en avaient subi aucun. Les facteurs de risque indépendants pour n’avoir pas subi les trois TPS recommandés étaient le statut de membre d’une Première Nation (rapport de cotes ajusté [RCa]: 1,78 [IC de 95 %: 1,62–1,96]), le fait de résider en région rurale éloignée (RCa 3,61 [IC de 95 %: 3,10–4,20]) et le recours exclusif à une sage-femme pour les soins prénatals (RCa 13,70 [IC de 95 %: 9,20–20,39]).

CONCLUSIONS : Presque toutes les femmes enceintes en Alberta ont subi un TPS au moins une fois durant leur grossesse, mais elles sont beaucoup moins nombreuses à avoir subi les TPS aux points recommandés dans le temps. Des interventions ciblant les femmes moins susceptibles de subir un dépistage prénatal pourraient contribuer à faire en sorte que les femmes enceintes reçoivent des soins précoces et appropriés pour la syphilis durant la grossesse.

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Authors and Affiliations

  1. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada

    Sabrina S. Plitt PhD

  2. Epidemiology and Surveillance Team, Alberta Health, 23rd Floor, ATB Place, 10025 Jasper Avenue, Edmonton, AB, T5J 1S6, Canada

    Mariam Osman MPH, Vanita Sahni MSc & Kimberley Simmonds PhD

  3. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Bonita E. Lee MD, MSc

  4. Alberta Health Services, Edmonton, AB, Canada

    Carmen Charlton PhD

Authors
  1. Sabrina S. Plitt PhD
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  2. Mariam Osman MPH
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  3. Vanita Sahni MSc
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  4. Bonita E. Lee MD, MSc
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  5. Carmen Charlton PhD
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  6. Kimberley Simmonds PhD
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Corresponding author

Correspondence to Kimberley Simmonds PhD.

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Conflict of Interest: None to declare.

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Plitt, S.S., Osman, M., Sahni, V. et al. Examination of a prenatal syphilis screening program, Alberta, Canada: 2010–2011. Can J Public Health 107, e285–e290 (2016). https://doi.org/10.17269/CJPH.107.5320

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  • DOI: https://doi.org/10.17269/CJPH.107.5320

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