Doctors call to expand syphilis testing during pregnancy amid recent surge 

April 19, 2024

A coalition of doctors are sounding the alarm on the need for increased syphilis testing for pregnant individuals, amid a recent surge of the sexually transmitted infection in U.S. newborns.

The American College of Obstetricians and Gynecologists (ACOG) published new guidance Thursday, recommending doctors screen pregnant individuals for syphilis three times during pregnancy.

Obstetricians, gynecologists and other obstetric care professionals are now advised to screen all pregnant individuals for syphilis at the first prenatal care visit, during the third trimester and again at birth.

Previous guidance recommended risk-based testing in the third trimester for those living in communities with high syphilis rates and for those at risk of acquiring the infection during pregnancy.

“There has been a near eightfold increase in congenital syphilis cases in the last decade or more, and from a public health perspective, we recognize that obstetrician–gynecologists and other obstetric care clinicians play a critical role,” Christopher Zahn, a fellow of ACOG, said in a statement.

Zahn said a timely diagnosis and treatment are “key” to reducing syphilis rates, noting the “majority” of cases can be prevented.

Syphilis is a sexually transmitted bacterial infection that can be contracted through direct contact with a sore, or through casual contact with objects like toilet seats, doorknobs, swimming pools, shared clothing or utensils. The infection can also spread from a pregnant person to a fetus.

More than 3,700 babies were born with congenital syphilis in 2022, marking the most cases in more than 30 years, the Centers for Disease Control and Prevention (CDC) said last year.

In its full advisory, the doctors coalition pointed to the CDC’s finding that nearly 9 in 10 congenital syphilis cases “could have been prevented with timely screening and treatment.”

Syphilis transmission to a fetus can lead to the baby having a low birth weight, and it increases the chances the mother will deliver too early or have a stillborn or miscarriage, according to the CDC.

At birth, a babies might not have signs or symptoms of the disease, but if they do not receive treatment, they can develop health issues within a few weeks. These problems include cataracts, deafness, seizures or death, the CDC added.

Benzathine penicillin G is the preferred treatment for syphilis during pregnancy, though the drug has been in short supply since last year. Pfizer, which is the only company manufacturing the drug, said last year it would take until at least the second quarter of 2024 to increase production enough to end the shortage.