Poster Session 3
Category: Health Equity/Community Health
Poster Session 3
Joe Haydamous, MD (he/him/his)
PGY1
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Department of Obstetrics and Gynecology, McGovern Medical School at UT Health, Houston, Texas, United States
Kayla M. Evans, BS
Medical Student (MS2)
McGovern Medical School - The University of Texas Health Science Center at Houston
Houston, Texas, United States
Laura Diab, MD (she/her/hers)
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Analuisa C. Mosqueda, MD
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Juan C. Padilla Ruiz, MD
PGY-1
UTHealth Houston
UTHealth Houston, Texas, United States
Sabrina C. DaCosta, MD
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Cassandra Igbe, MPH
Research Associate
The University of Texas Health Science Center at Houston
The University of Texas Health Science Center at Houston, Texas, United States
Mason Collie, BS
McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Irene A. Stafford, MD, MPH, MS
Associate Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Emergency departments (EDs) offer a critical opportunity to identify syphilis during pregnancy. However, patient factors that influence test uptake and follow-up remain understudied. This study evaluates the role of social determinants of health (SDOH) in syphilis test acceptance and linkage to prenatal care among pregnant ED patients.
Study Design:
After Institutional Review Board approval, a prospective cohort study was conducted at the University of Texas Health Science Center in Houston, TX. Pregnant patients presenting to the ED between 11/05/24 and 06/01/25 were offered opt-out syphilis testing and linkage to prenatal care. Key SDOH variables included race/ethnicity, primary language, insurance type, prenatal care status, partner presence, and substance use. Multivariable logistic regression identified predictors of test acceptance and prenatal care follow-up.
Results:
Of 230 patients approached, 178 (77%) accepted testing. Hispanic patients had significantly higher odds of accepting testing than non-Hispanic White patients (OR = 13.6, 95% CI: 1.5–308.6, p = 0.036), while patients who identified Spanish as their primary language had lower odds (OR = 0.11, 95% CI: 0.006–0.68, p = 0.046). Patients without prenatal care were more likely to accept testing (OR = 0.31, 95% CI: 0.14–0.66, p = 0.003), and those with Medicaid (OR = 0.38, 95% CI: 0.16–0.87, p = 0.024) or self-pay status (OR = 0.19, 95% CI: 0.07–0.50, p = 0.001) were less likely to accept testing compared to privately insured patients (Table 1). Among tested participants, 88 (49.4%) followed up with prenatal care. Patients who identified Spanish as their primary language (OR = 0.24, 95% CI: 0.08–0.69, p = 0.010) and self-pay patients (OR = 0.13, 95% CI: 0.04–0.36, p < 0.001) had lower odds of follow-up (Table 2). Prenatal care, partner presence, and substance use were not significant.
Conclusion:
Preferred language, insurance status, and ethnicity impact test uptake and prenatal care follow-up. Addressing these communication and financial barriers may help reduce disparities in perinatal syphilis care.