Hindawi Publishing Corporation Infectious Diseases in Obstetrics and Gynecology Volume 2006, Article ID 56504, Pages 1–3 DOI 10.1155/IDOG/2006/56504 Clinical Study Assessment of the Value of Rescreening for Syphilis in the Third Trimester of Pregnancy Rodney K. Edwards, Margaret Bennett, Carrie Langstraat, and Daina Greene Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL 32610-0294, USA Received 12 January 2006; Revised 6 March 2006; Accepted 28 March 2006 Objectives. Our aim is evaluating the need for repeating tests for syphilis on pregnant women in the third trimester. Study design. A single-center retrospective cohort study was performed on all women delivering 7/03–6/04. Results. During the study interval, 2244 women delivered at our hospital. Of those women having available records and attending at least one prenatal visit, 1940 (98.9%) were screened for syphilis at the ﬁrst prenatal visit. Of the 1627 women beginning prenatal care prior to 27 weeks and delivering after 32 weeks, 1377 (84.6%) were rescreened in the third trimester. No cases of syphilis were identiﬁed with either the initial (upper limit of 95% CI 0.24%) or repeat (upper limit of 95% CI 0.34%) screening. Conclusions. In our obstetric population, syphilis is so uncommon that mandated prenatal screening on more than one occasion seems unjustiﬁed and laws requiring repeated screening should be reevaluated. Copyright © 2006 Rodney K. Edwards et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. INTRODUCTION The Centers for Disease Control and Prevention recommend screening all pregnant women for Chlamydia trachomatis infection and syphilis at the ﬁrst prenatal visit. Repeated screening for these infections during the third trimester is recommended for those women at increased risk for con- tracting these infections. Screening for gonorrhea once or twice during pregnancy is recommended for those women at risk [1]. Most states have laws requiring that women undergo screening for syphilis at least once during pregnancy. Nine states, including Florida, have statutory requirements that pregnant women undergo screening for syphilis both at the ﬁrst visit and again in the third trimester [2]. At least in Florida, there is no similar law requiring prenatal screening either for gonorrhea or Chlamydia trachomatis infection. Screening for sexually transmitted diseases (STD) during pregnancy has been advocated as being cost-eﬀective as long as the prevalence exceeds 1% [3]. The reported prevalence of gonorrhea during pregnancy varies widely, with rates vary- ing between 0 and 10%, depending on the risk status of pa- tients [4–6]. The prevalence of Chlamydia trachomatis infec- tion during pregnancy is higher than that of gonorrhea [7, 8]. Syphilis is the least common of the sexually transmitted in- fections that are endemic to the United States. In 2003, cases of primary and secondary syphilis occurred at a rate of 2.5 cases per 100 000 population [9]. Since reaching a nadir in 1999, the number of cases has increased slightly over the past few years. However, this increase has been conﬁned to men who have sex with men [9]. We sought to evaluate the prevalence of syphilis in the obstetric population delivering at Shands Hospital at the University of Florida. By doing so, we wanted to evaluate the utility of repeating screening tests for syphilis during the third trimester. MATERIAL AND METHODS We performed a historical cohort analysis of all women de- livering at Shands Hospital at the University of Florida from 1 July 2003 to 30 June 2004. For consideration of screen- ing for syphilis at the ﬁrst prenatal visit, all women who at- tended at least one prenatal visit were included. For consid- eration of the utility of repeating the screening in the third trimester, women were included in the cohort if they began prenatal care prior to 27-weeks gestation and delivered af- ter 32 weeks, so as to allow a minimum of 6 weeks between