ETHNIC-RACIAL DISPARITY IN THE PREVALENCE OF SYPHILIS IN PREGNANT WOMEN: A SYSTEMATIC REVIEW
Syphilis. Systematic Review. Prenatal Care. Health of Ethnic Minorities.
Introduction: Syphilis has a high global prevalence and is one of the leading causes of maternal and fetal morbidity and mortality. When it occurs during pregnancy, it should be diagnosed and treated during prenatal care. Marginalized and vulnerable populations, such as the Black population, are most affected by the infection. Objective: To compare the prevalence of gestational syphilis in women according to race or ethnicity through a systematic review. Method: This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines as a writing guide. The study protocol was registered on the PROSPERO platform under number CRD42024605429. Article searches were conducted in the PubMed, Web of Science, Lilacs, Scopus, and Cinahl databases, as well as Google Scholar. Cross-sectional studies that reported the prevalence of gestational syphilis by race/skin color and/or ethnicity were included. The Joanna Briggs Checklist for Analytical Cross-Sectional Studies was used to assess the risk of bias. All steps were performed by independent evaluators. Results: 4,536 studies were found, of which 143 were selected for full-text reading. Eleven articles analyzed the prevalence of gestational syphilis according to race, skin color, or ethnicity. There were discrepancies in prevalence across ethnic groups: Black women had higher prevalence rates than other groups, with prevalence rates ranging from 0.046 to 61.1%. Conclusions: The studies included in this review demonstrate ethnic and racial inequities in the prevalence of gestational syphilis, with a notable higher prevalence among Black women.