Rates of Congenital Syphilis During Pregnancy

“Why is my provider recommending testing me for syphilis so many times during my pregnancy?”

Alarming increases in the rates of congenital syphilis (when a baby is born with syphilis) over the past five years has prompted a change in practice amongst providers to increase screening for syphilis for pregnant patients. 

For pregnant patients, syphilis poses a serious threat to both their health and the well-being of their unborn child. Because syphilis can cross the placenta, it can infect the developing fetus.

Congenital syphilis can cause a variety of severe conditions for a newborn baby, including hearing loss, visual problems, abnormal bone growth and some neurologic abnormalities that can significantly impact their lives. 

Cases of Syphilis the Midwest:

• 70 cases of syphilis were reported across Nebraska in 2017. 
• 255 cases were reported (364% increase) in 2021.
• Incidence in females increased 813% from 2017 to 2021 (8 cases to 65).
• 4 cases of congenital syphilis occurred between 2017 and 2021. 

Most cases of congenital syphilis can be prevented by early screening and treatment. Besides congenital syphilis, other complications in regard to pregnancy can include:

• Miscarriage. Syphilis can increase the risk of miscarriage, especially in the early stages of pregnancy.
• Stillbirth. In later stages, syphilis can lead to stillbirth, meaning the baby is born dead.

Spread primarily by direct contact with a syphilis sore during sexual activity, syphilis tends to be a chronic infection that can progress through several stages, some of which are asymptomatic. If it’s untreated, it can be latent or without symptoms but still contagious for years. 

Who should get tested?

• All pregnant patients. The Centers for Disease Control and Prevention (CDC) recommends that all pregnant patients get tested for syphilis at their first prenatal visit and again in the third trimester. ACOG also recommends testing again at time of birth - in the hospital. 
• Patients with risk factors. Patients who have multiple sexual partners, a history of STIs, or a partner who has syphilis should get tested more frequently.

Many states, including Nebraska, require that pregnant patients be screened for syphilis during their first prenatal visit. 

If you are pregnant or planning to become pregnant, don't delay getting tested for syphilis. Early detection and treatment can protect you and your baby from the serious consequences of this infection. 

Steps to Reduce Risk

1. Practice safer sex. 
2. Get tested regularly, even if you don’t have symptoms. 
3. Know your partner's status. 
4. Limit your number of partners. 
5. Avoid sharing personal items that may come into contact with syphilis sores (razors, toothbrushes, towels). 

Seek medical attention if you experience any symptoms of syphilis, such as sores, rashes or other unusual changes. Early treatment with antibiotics can prevent complications and stop the spread of the infection. Reach out to our CHI Health Women's Health team with more questions. Same day appointments are likely available - so call your provider as soon as a concern arises. 

Sources:

https://dhhs.ne.gov/han%20Documents/ADVISORY03212022.pdf