Congenital Syphilis
What is syphilis?
Syphilis is a bacterial infection, caused by the bacteria Treponema pallidum. It is passed on when a person comes in contact with a syphilitic sore, known as a chancre—typically during vaginal, anal, or oral sex.
What is congenital syphilis?
Congenital syphilis occurs when syphilis is passed to a fetus during pregnancy. Syphilis during pregnancy can lead to miscarriage, low birth weight, premature delivery or stillbirth, death shortly after birth, and/or lifelong health issues.
Congenital syphilis can be prevented by timely testing and treatment of syphilis during pregnancy. Additionally, preventing the initial syphilis infection is important and can be prevented by using safer sex practices, including using condoms.
Congenital Syphilis on the Rise
Congenital syphilis cases have been on the rise. Cases have more than tripled in recent years. More than 3,800 cases were reported in 2023 alone. This is the highest number reported in one year, since 1994.
Resources for Providers, Patients, and Advocates
- Syphilis and Congenital Syphilis Resource List (Child Trends)
- CME/ABIM MOC/CE: Syphilis and Congenital Syphilis on the Rise – How to Protect Your Patients (CE Opportunity)
- Missed Opportunities for STI Testing in Contraceptive Care (Child Trends)
- ACOG Labor of Love Podcast | Season 3, Episode 2 American College of Obstetrics and Gynecology: Podcast episode on Congenital Syphilis
- Clinician Guide for Trauma-Informed Care – NCSH National Coalition for Sexual Health
- Words Matter: Minimizing STI Stigma in Healthcare Settings – ASHA e-learning course from the American Sexual Health Association
- Program Operation Considerations for Sexually Transmitted Infection Prevention PDF – CDC (Centers for Disease Control and Prevention)
- National STI Curriculum Training Module: Syphilis During Pregnancy and Congenital Syphilis (University of Washington and the CDC)
Where to Get Tested? https://gettested.cdc.gov/
Home Testing Options https://www.ashasexualhealth.org/testing-for-stis-at-home/
Prenatal Care: Prenatal care is essential in preventing congenital syphilis. Here are some resources to help you find prenatal care.
Syphilis Campaign Planning Resources (ASTHO)
Missed Opportunities for STI Testing in Contraceptive Care (Child Trends)
STI Testing in Emergency Departments (ASHA)
Social Media Toolkits (ASHA)
Screening Recommendations for Congenital Syphilis
Testing for congenital syphilis is recommended for all pregnant patients in the first trimester or at the first prenatal visit. Additional testing is recommended during the third trimester and at delivery. To learn more about testing recommendations, click the links below.
Congenital Syphilis Screening Laws
State laws surrounding syphilis testing during pregnancy can vary greatly. Some states require testing at least three times—at the first prenatal visit, during the third trimester, and at delivery. Some state laws require testing at one or more of these times and only require additional testing based on risk. Risk, as defined in these laws, can mean a variety of things, from having no prior prenatal care, no evidence of prior testing, prior syphilis infection, living in an area with high rates of syphilis, or behavioral factors like multiple sex partners or exchanging sex for money. A few U.S states don’t require testing for syphilis during pregnancy (North Dakota, Minnesota, Iowa, Wisconsin, Maine, and Hawaii). Still, many people in these states will be tested for syphilis during pregnancy.
The CDC offers complete information on legal requirements for syphilis screening among pregnant women by state.