Amid surge in syphilis cases, doctors are calling for more testing during pregnancy

The nation’s largest coalition of obstetricians issued an urgent warning Thursday calling on doctors to expand testing for syphilis during pregnancy amid a surge of cases in recent years.

The American College of Obstetricians and Gynecologists updated its recommendations, advising a routine blood screening at the first prenatal visit and screenings in the third trimester of pregnancy and at birth. This contrasts with previous recommendations, which called for testing in the third trimester exclusively for individuals living in communities with high syphilis rates and for those at risk of syphilis exposure during pregnancy.

“We’re always trying to create healthier families, and some of the diseases that we can easily diagnose and treat are things that we should prioritize, especially when they can be devastating to a baby,” said Laura E. Riley, chair of the obstetrician coalition’s immunization work group. Riley helped write the guidance.

“Sometimes, it’s difficult to know that you’ve been exposed to syphilis, and it’s not like you can raise your hand and say, ‘I have this, please give me treatment,’ because you may not even know you have it,” said Riley, chair of obstetrics and gynecology at Weill Cornell Medicine in New York.

Rates of syphilis have been skyrocketing, with cases hitting their highest level since the 1950s. Reported syphilis cases increased 80 percent from 2018 to 2022 in the United States, soaring from about 115,000 cases to more than 207,000, according to the Centers for Disease Control and Prevention.

In 2022, more than 3,700 babies were born with syphilis, with 231 stillbirths and 51 infant deaths attributed to transmission of syphilis from pregnant people to their babies.

Experts say these rising numbers reflect decreased condom use and an uptick in substance use, The Washington Post reported.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. When a pregnant woman is infected with syphilis, the infection can pose severe consequences for her and the unborn baby. Left untreated, syphilis can progress to advanced stages and damage organs and nerves.

It can also be transmitted to the fetus during pregnancy or at childbirth, resulting in congenital syphilis, which can lead to severe health problems for the baby, including premature birth, low birth weight, stillbirth, developmental delays and other complications.