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As Syphilis Cases Soar in Newborns, ACOG Advises More Testing During Pregnancy

— Group now recommends screening three times instead of once

MedpageToday
A 1972 CDC microscope image of a Treponema pallidum bacterium
(Susan Lindsley/CDC via AP)

With syphilis cases in U.S. newborns skyrocketing, a doctors group now recommends that all pregnant patients be screened three times for the sexually transmitted infection.

The American College of Obstetricians and Gynecologists (ACOG) on Thursday saying the screening should be done at the first prenatal visit, during the third trimester, and at birth. Though the screening isn't required, health professionals generally follow the group's recommendations.

"The cases of congenital syphilis are definitely climbing, and they've been climbing over the last 10 years. And it's completely preventable ... It's unacceptable," said Laura Riley, MD, who chairs the Department of Obstetrics and Gynecology at Weill Cornell Medicine and helped with the guidance. "We need to be able to do better diagnostics and treatment."

Previously, the group recommended one test in the third trimester -- but only for women considered at risk of getting syphilis during pregnancy or those living in communities with high rates of the disease. But this risk-based approach is "how we get into trouble because we're missing cases," Riley said.

In 2022, the CDC said more than 3,700 babies were born with congenital syphilis, the most in more than 30 years. U.S. health officials called for stepping up prevention, including screening which is done with a blood test.

In its advisory, the ob/gyn group said CDC statistics show nearly nine in 10 congenital syphilis cases that year "could have been prevented with timely screening and treatment."

Infections during pregnancy are generally treated with at least two doses of penicillin. Babies born to women with untreated syphilis may be stillborn or die shortly after birth. The can also cause other problems in newborns, such as deformed bones, severe anemia, blindness, or deafness.

"I hope that everyone takes it seriously," Riley said. Kids with congenital syphilis may have birth defects that can be devastating -- "which is incredibly sad."