Syphilis A sexually transmitted infection brought on by bacteria.
During pregnancy, the bacteria could be passed from a mother with untreated syphilis, called syphilis. Maternal syphilisto her baby within the womb, causing the fetus to contract. Congenital syphilis.
In January 2026, the US Centers for Disease Control and Prevention reported that rates of maternal syphilis 28% increase from 2022 to 2024.only 280 to about 360 cases per 100,000 births.
I’m one. Public health researcher and infectious disease nurse practitioner. I study disparities in sexually transmitted infections, or STIs, and I’m currently conducting a study Syphilis in pregnancy.
An ideal storm of things behind the boom
Two aspects specifically must be taken into consideration to grasp the sharp rise in cases.
One is the rise in syphilis cases in the final population – which naturally results in a rise in maternal syphilis – and the opposite is particular variables resembling funding and barriers to care that affect pregnant women on the subject of the spread of the disease.
The overall trend of rising syphilis rates is the results of what I’d describe as an ideal storm of things, from lack of funding to COVID-19. Syphilis infection rates within the United States Growing steadily since 2000..
In 2018, there was one A rapid increase in this rateAs the group primarily affected by this STI has shifted from men who’ve sex with men. The general population of both men and women.
This change led to a rise in maternal syphilis rates, which led to 700% increase in cases of congenital syphilis Since 2015
Public health funding for all sexually transmitted infections except HIV has stagnated for a long time. About US$160 million annually. Accounting for inflation and rising costs, this leads to a 40% reduction in spending power today.
Unfortunately, yearly Congress proposes Reduced funding for both STI and health care access programs. These cuts have largely not been implemented in the ultimate appropriations packages.
But yearly, More drastic cuts are proposed.. The 2026 appropriations propose to consolidate and cut three programs – HIV, STI and TB. $70 million from joint programs.
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On top of this funding shortfall, The Covid-19 pandemic Many of mine grew Basic barriers to access to health care This allowed the ever-increasing rate of syphilis to extend rapidly. During the pandemic, safety net clinic staffing and hours were reduced, which Availability of screening and treatment services.
Another consider the rise in syphilis cases is sex change. behavior over the past 25 years. During the early days of the HIV epidemic within the Nineteen Eighties, sexual attitudes that led to HIV modified rapidly, resulting in safer sex practices. However, by the early 2000s, higher HIV treatments meant that HIV was No more death penaltybut a manageable chronic condition.
While this was definitely excellent news, it also meant that safer sex practices began to say no, which in turn increased the possibilities of contracting HIV and other STIs, including syphilis.
The role of stigma
Social stigma and prejudices from Both health care providers and patients themselves This can affect whether someone gets tested or seeks treatment for symptoms.
Although it affects all patients, it is particularly problematic for pregnant patients. Pregnant women needs to be screened for syphilis in the primary and third trimesters. But a health care provider may assume that asking questions on a patient’s sexual behaviors or ordering the crucial tests is unnecessary, especially within the case of patients who’ve been in long-term monogamous relationships.
Additionally, the patient could also be reluctant to confess to dangerous sexual behaviors, or may not realize that they’ve been brought on by a partner’s infidelity.
Barriers to care.
Another driver of the rise in maternal syphilis is difficulty. Access to prenatal care: 1 in 4 pregnant women There is no access to prenatal care. In their first trimester.
Barriers to accessing health care vary based on race and ethnicity, availability of transportation, economic status, rural or urban location, and insurance status. Most of those aspects are present in all health conditions, but for pregnancy, insurance status presents a specific barrier. Pregnancy qualifies for Medicaid enrollment if income requirements are met. However, this enrollment can sometimes take months, and a few prenatal care clinics is not going to see patients until coverage is approved.
This means patients are out of the primary trimester before they’re screened for syphilis. But first trimester screening and intervention is the very best. Ability to reduce the risk of congenital syphilis
Know the symptoms
Syphilis is characterised by various symptoms In each of the four stages of the disease. During the initial phase, inside a couple of days to a couple of weeks of infection, most patients develop a painless ulcer at the positioning of exposure. This lesion may go unnoticed and resolve by itself. However, the infection stays.
The secondary stage occurs 3 to six months after exposure. Patients normally have flu-like symptoms, possibly some weight reduction, swollen lymph nodes and a rash covering the chest and back. This rash doesn’t itch, and it may well spread to the palms of the hands or the soles of the feet. Other symptoms include hair loss, mouth sores, hearing loss and vision changes, but not all of those symptoms may appear. This phase normally lasts for a couple of weeks after which resolves with or without treatment.
The disease then enters a latent phase, when the bacteria can remain lively within the body without causing severe symptoms and may last for a long time.
Finally, 40% to 60% of patients with untreated syphilis progress to the third stage of the disease, which may result in any variety of opposed outcomes, including seizures, heart defects, bone growths, skin growths, confusion, and dementia.
Transmission and treatment
Syphilis bacteria can easily spread through the placenta as a part of the shared blood supply between mother and fetus. This is almost certainly to occur throughout the first yr when an individual is infected with syphilis, although the syphilis bacteria can spread to the fetus. At any stage of infectionDue to which the kid born is generally known as congenital syphilis.
Congenital syphilis This can lead to a variety of opposed outcomes, probably the most serious of that are miscarriage or stillbirth. If the fetus survives, long-term growth retardation, blindness, hearing loss, everlasting damage to teeth and bones, heart defects and rashes can occur. Symptoms of congenital syphilis may appear soon after birth, or might not be recognized until the kid is over 2 years old, when molars erupt, or bone growth and changes change into more pronounced.
Congenital syphilis could be treated with antibiotics Preventing disease progression But cannot undo any negative results already done.
Fortunately, syphilis is well treated with antibiotics resembling a long-acting penicillin injection right into a muscle. Unfortunately, long-acting intramuscular injection In short supply. But anyone who is not pregnant and doesn’t have neurological symptoms — requiring intravenous penicillin — could be cured. A course of another antibiotic, doxycycline, for 14-28 days.
Prevention of Maternal Syphilis
The fundamental approach to prevention is to make use of condoms when sexually lively, or to make sure that sexual partners have tested negative for all sexually transmitted infections and are having sex exclusively with one another. In some cases, an individual can take Doxycycline post-exposure prophylaxis, also known as doxyPEP.Plan B could be taken inside 72 hours of sexual intercourse to stop syphilis, as can Plan B to stop pregnancy.
It is probably the most effective strategy to prevent congenital syphilis. Universal screening of all pregnancies At three points: During first trimester, third trimester and at delivery.
However, some published studies and a paper currently under review show just that. 80% to 90% of pregnancies with private health care insurance And [56% to 90% of those on Medicaid] are Screening for syphilis At least once throughout pregnancy.