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. 2025 Jun 18;146(3):434-436.
doi: 10.1097/AOG.0000000000005984.

Rural-Urban Differences in Maternal Syphilis Trends in the United States, 2016-2023

Clara E Busse  1 , Danielle R Gartner, Katy B Kozhimannil
Affiliations

Rural-Urban Differences in Maternal Syphilis Trends in the United States, 2016-2023

Clara E Busse et al. Obstet Gynecol. .

Abstract

Cases of syphilis during pregnancy (maternal syphilis) have risen dramatically in the United States in recent years, with racially minoritized groups experiencing high rates and large increases. Rural residents face diminishing access to maternity care, but prior research has not examined rural-urban differences in maternal syphilis. Using expanded natality data from the Centers for Disease Control and Prevention, we compared maternal syphilis rates among rural and urban residents (2016-2023) and showed that, since 2021, rural rates have exceeded urban rates. From 2016 to 2023, maternal syphilis rates quintupled in rural areas and tripled in urban areas. Rates and increases are particularly high among American Indian and Alaska Native and Black rural residents compared with their urban counterparts.

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Conflict of interest statement

Financial Disclosure Danielle R. Gartner disclosed the following: the University of Minnesota paid her travel expenses to deliver a talk to faculty and staff in 2024. The topic was related to American Indian and Alaska Native maternal health but did not include any specific discussion of syphilis. The other authors did not report any potential conflicts of interest.

References

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