ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2026
Uptake of prenatal syphilis screening and its determinants in Ontario, Canada: a population-based retrospective cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTimely prenatal syphilis screening is critical for preventing congenital syphilis infection. We aimed to examine prenatal syphilis screening patterns in Canada and to identify factors associated with missed or late screening.
methodsFor this population-based retrospective cohort study, we used linked provincial administrative health data from Ontario, Canada. We included pregnancies (> 20 wk gestation) resulting in live births or stillbirths from January 2018 to December 2023. Missed prenatal syphilis screening (at any point during pregnancy or at delivery) or late screening (either during the third trimester or at delivery) were the primary outcomes. We evaluated individual-level and external factors associated with the outcomes using modified Poisson regressions with generalized estimating equations. We reported adjusted relative risks (RRs) and 95% confidence intervals (CIs).
resultsAmong 551 706 pregnancies (median maternal age 31 yr, interquartile range 28 to 34 yr), 507 169 (91.9%) were screened for syphilis, and 435 162 (78.9%) received first-trimester screening. Screening rates increased over time and varied by geography and individual risk factors. Those tested for syphilis within 1 year before conception were more likely to miss screening during pregnancy (adjusted RR 2.12, 95% CI 2.08 to 2.16). Initial screening at delivery was associated with being younger (15 to 19 yr v. 30 to 39 yr) at conception (adjusted RR 4.01, 95% CI 3.33 to 4.81), having injection or general drug use within 3 years before conception (adjusted RR 3.78, 95% CI 3.11 to 4.59), and living in a neighbourhood of the lowest income quintile (adjusted RR 1.59, 95% CI 1.40 to 1.80). Similar factors were associated with initial screening during the third trimester.
interpretationIn Ontario, 1 in 5 pregnancies did not receive timely first-trimester screening for syphilis, and we identified sociodemographic and behavioural factors associated with late screening. These findings point to modifiable gaps in system and service delivery and highlight the need for coordinated clinical, public health, and community-based strategies to improve coverage and timeliness of prenatal syphilis screening.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.