• Posted April 19, 2024

Screen Pregnant Women for Syphilis, Ob-Gyn Group Advises

All expecting mothers should get a blood test for syphilis three times during pregnancy, new guidance issued by the American College of Obstetricians and Gynecologists recommends.

The practice advisory calls on doctors to test for syphilis at a pregnant woman’s first prenatal care visit, then again during the third trimester and at birth.

The advisory comes in response to a dramatic increase in syphilis rates among pregnant women and newborns.

Previously, ACOG recommended risk-based testing in the third trimester only for women living in communities with high rates of syphilis or women at high risk of becoming infected during pregnancy.

Syphilis can damage the heart and brain and cause blindness, deafness and paralysis unless it’s treated. When transmitted during pregnancy, it can cause miscarriage, lifelong health problems and infant death.

In February, the U.S. Centers for Disease Control and Prevention reported that maternal syphilis rates had tripled in recent years.

More than 10,000 women who gave birth in 2022 had syphilis, up from about 3,400 cases in 2016, the CDC found.

The ACOG advisory paints an even more dire picture, saying that U.S. rates of babies born infected with syphilis had increased by 755% between 2012 and 2021.

“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,” said Dr. Christopher Zahn, ACOG’s interim CEO and chief of clinical practice and health equity and quality.

Notably, two in five infants born with syphilis had moms who didn’t receive any prenatal care, the advisory said.

“Therefore, it is important to make any health care encounter during pregnancy -- including those in emergency departments, jails, syringe service programs and maternal and child health programs -- an opportunity to screen for syphilis,” the advisory reads.

About 88% of syphilis cases in newborns could be prevented with timely screening and treatment, ACOG said.

“Timely diagnosis and treatment are key to reducing syphilis rates, and yet we are currently facing several challenges, including treatment shortages, lack of access to prenatal care and the stigma that surrounds sexually transmitted infections,” Zahn said in an ACOG news release. “Congenital syphilis can have devastating effects. We know that a majority of cases can be prevented, so additional routine screening during pregnancy is one important step that clinicians can take that could potentially be lifesaving."

More information

The March of Dimes has more about syphilis in pregnancy.

SOURCE: American College of Obstetricians and Gynecologists, news release, April 18, 2024