Congenital syphilis is a sentinel health event

The problem

In 2021, there were 2,855 cases of congenital syphilis reported for a rate of 77.9 per 100,000 live births. From 2012 to 2021, the number of cases of congenital syphilis increased 754.8% (334 to 2,855 cases), concurrent with a 676.2% increase (2.1 to 16.3 per 100,000 lives) in the rate of primary and secondary syphilis among women aged 15 to 44 years.¹

Maternal syphilis is associated with a 21% increased risk for stillbirth, 6% increased risk for preterm delivery, and 9% increased risk for neonatal death.²

Optimal treatment of syphilis during pregnancy is estimated to reduce the risk of congenital syphilis by 98%, stillbirth by 82%, preterm birth by 64%, and neonatal mortality by 80%.³& Syphilis is treatable and curable with penicillin. One in two newborn syphilis cases in the United States occur due to gaps in testing and treatment during prenatal care.³

Congenital syphilis: missed prevention opportunities¹

You can make a difference — screen appropriately² and treat early⁴!

Universal screening: All pregnant women at their first prenatal visit. Treat immediately.

High risk screening: Twice in third trimester (28 weeks and at delivery). Ask, document, rescreen:

• History of sex with multiple partners
• Sex in conjunction with drug use or transactional sex
• No prenatal care or late entry
• Methamphetamine or heroin use
• Unstable housing or homelessness
• Incarceration of the woman or her partner
• Prior syphilis diagnosis

High prevalence screening: Twice in third trimester (28 weeks and at delivery) for pregnant women who live in communities with high rates of syphilis. For more information, visit https://gis.cdc.gov/grasp/nchhstpatlas/maps.html.

Do you know the law in your state? Check your state health department website for updated recommendations.

Do you practice in a high prevalence area? Universal screening in the third trimester and at birth are recommended.