CDC is recommending concerted action to stop the rise in syphilis cases in newborns and continues to sound the alarm about the consequences of a rapidly growing epidemic of sexually transmitted infections in the United States. Syphilis during pregnancy can have tragic consequences, including miscarriage, stillbirth, death of the baby, and lifelong medical problems. Syphilis in newborns occurs when mothers are not screened or given timely treatment during pregnancy.
New data from the CDC reveals that more than 3,700 babies were born with syphilis in 2022, which was more than ten times the number of cases in 2012. The increase in syphilis cases in newborns follows the increase in cases of syphilis among women of reproductive age in combination with social and economic factors that create barriers to high-quality prenatal care, and with the ongoing decline in infrastructure and resources for prevention.
“The congenital syphilis crisis in the United States has exploded at a heart-breaking rate,” said CDC Chief Medical Officer Debra Houry, MD, MPH. “New measures are needed to prevent more family tragedies. “We are calling on healthcare providers, public health systems, and communities to take additional steps to connect mothers and babies to the health care they need,” she added.
Key findings
- Nearly 9 in 10 cases of syphilis in newborns in 2022 could have been prevented with early screening and treatment during pregnancy.
- More than half were among people who tested positive for syphilis during pregnancy but did not receive adequate or timely treatment.
- Nearly 40 percent were among mothers who did not receive prenatal care.
One of the biggest risk factors for syphilis for some people is where they live. According to previous CDC data, in 2021, more than 70 percent of the U.S. population lived in counties considered to have high rates of syphilis among women of reproductive age (above the WHO goal). the Healthy People 2030 initiative ).
Barriers to timely screening and treatment during pregnancy
Missed opportunities to prevent syphilis in newborns during pregnancy are due to a combination of barriers—at the individual and system levels—to timely syphilis screening and treatment. Individual-level barriers could include lack of health insurance and substance use disorder, while system-level barriers could include systemic racism and limited access to health care.
Personalized prevention strategies are crucial to address disparities in syphilis in newborns
People of racial and ethnic minorities bear the brunt of the newborn syphilis epidemic. Although these cases are increasing overall, babies of Black, Hispanic, or American Indian or Alaska Native mothers were up to 8 times more likely to be born with syphilis in 2021 than babies of White mothers .
Such disparities stem from decades of deeply entrenched social determinants of health that create greater barriers to quality health care services and produce health inequities, such as higher rates of syphilis in some communities. Community health workers, including local patient navigators, case managers, and disease intervention specialists , are a crucial part of developing personalized strategies to reduce newborn syphilis cases in each community. They play one of the most powerful roles in addressing racial and ethnic disparities in congenital syphilis.
“The congenital syphilis epidemic is an unacceptable crisis in the United States. “All pregnant mothers—no matter who they are or where they live—deserve access to care that protects them and their babies from preventable diseases,” said Jonathan Mermin, MD, MPH, director of the National Center for Pregnancy Prevention. HIV, Viral Hepatitis, STDs and Tuberculosis. “Our nation should be proactive and think beyond the OB-GYN offices and bridge the gaps in prevention. Every encounter a healthcare provider has with a patient during pregnancy is an opportunity to prevent congenital syphilis,” he added.
CDC is urgently urging public health leaders and any health care provider with patients of pregnant or reproductive age to do the following:
- Consider initiating syphilis treatment immediately after a positive result on a rapid syphilis test during pregnancy, if the patient faces greater barriers to continued care (and still refer her for a full confirmatory test for optimal follow-up).
- Use rapid syphilis testing and treatment during pregnancy in settings such as emergency rooms, syringe services program sites, prisons or jails, maternal and child program sites.
- Address syphilis before pregnancy in counties with high rates of syphilis , by offering screening to sexually active women and their partners, as well as people with other risk factors for syphilis .
- Collaborate with local community health workers who can help overcome additional barriers to syphilis screening and treatment during pregnancy.
Due to the increase in cases of syphilis and congenital syphilis in the United States, senior leadership at the Department of Health and Human Services (HHS) established the Federal Task Force on the National Syphilis and Congenital Syphilis Syndemic dedicated to leading a national public health response to syphilis and congenital syphilis. The overall mission of this task force is to address the syphilis and congenital syphilis syndemic, reduce their rates, promote health equity, and share resources with affected communities.
For more information about this report, visit www.cdc.gov/vitalsigns .
