Rising Syphilis Rates in Pregnant Women: Risks and Prevention

Syphilis rates among pregnant women in the United States have reached their highest levels since the early 1990s, according to a new report from the National Center for Health Statistics (NCHS). The data show a 222% increase in maternal syphilis cases between 2016 and 2022, followed by an additional 28% rise from 2022 to 2024. This surge underscores critical gaps in prenatal screening and care, particularly among marginalized communities and raises urgent concerns about preventable congenital syphilis in newborns.

Rising Rates Reflect Systemic Gaps in Prenatal Care

The NCHS report, released in early 2026, analyzes trends in maternal syphilis using birth certificate data and surveillance systems. In 2024, there were 887 cases of maternal syphilis per 100,000 births among Black women, 411 per 100,000 among Hispanic women, and 188.2 per 100,000 among white women. The highest burden was observed among Native American and Alaska Native women, with a rate of 2,145 cases per 100,000 births — more than 11 times the rate for white women.

These disparities reflect long-standing inequities in access to prenatal care. A cited study found that 35% of women of reproductive age in the U.S. Live in areas without a maternal health provider, a gap that disproportionately affects low-income individuals, people of color, and those in rural communities. Barriers such as lack of insurance, high deductibles, transportation challenges, and clinic closures — including maternity ward shutdowns in rural hospitals — prevent many women from receiving timely screenings.

Syphilis Is Treatable — But Only If Detected

Syphilis, caused by the bacterium Treponema pallidum, is a sexually transmitted infection that can be passed from mother to child during pregnancy or delivery, resulting in congenital syphilis. While the infection often presents no symptoms in its early stages, It’s easily detectable with a simple blood test and treatable with penicillin, even during pregnancy.

Without treatment, syphilis can lead to severe outcomes for infants, including miscarriage, stillbirth, neonatal death, and lifelong complications such as developmental delays, bone deformities, and neurological damage. However, when diagnosed and treated early, congenital syphilis is nearly entirely preventable.

Updated Guidelines Call for Triple Screening

In response to the rising trend, the American College of Obstetricians and Gynecologists (ACOG) issued updated guidelines recommending that all pregnant individuals be screened for syphilis three times during pregnancy: at the first prenatal visit, during the third trimester, and at the time of delivery. This represents a shift from prior guidance, which often recommended only first-trimester screening unless risk factors were present.

The Centers for Disease Control and Prevention (CDC) supports this approach, estimating that 9 in 10 cases of congenital syphilis could be prevented with timely testing and appropriate treatment. Yet, CDC data from 2022 show that 40% of mothers whose babies were born with syphilis did not receive adequate prenatal care — either missing screening entirely or not receiving treatment after a positive test.

Public Health Response and Resources

Health officials emphasize that expanding access to prenatal care and normalizing routine syphilis screening are critical steps in reversing the trend. Public health campaigns are increasingly focusing on outreach to underserved populations, including mobile clinics, community health centers, and partnerships with tribal organizations.

For individuals seeking testing or care, several reliable resources are available:

• Get tested: Visit gettested.cdc.gov to locate a nearby clinic offering free or low-cost STI screening.

• Home testing: Learn about FDA-cleared at-home syphilis test options through trusted sexual health providers.

• Prenatal care support: Access guidance from the Office of Disease Prevention and Health Promotion’s “Have a Healthy Pregnancy” tool, March of Dimes’ local support network, and Planned Parenthood’s prenatal care directory.

As syphilis continues to re-emerge as a public health concern in maternal and infant health, experts stress that the tools to prevent congenital syphilis already exist. The challenge lies not in medical capability, but in ensuring equitable access to testing, treatment, and comprehensive prenatal care for all pregnant people, regardless of income, race, or geography.