Syphilis in Pregnancy: Urgent Need for Universal Screening and Timely Treatment

Untreated or inadequately treated syphilis during pregnancy can lead to congenital syphilis, a condition that poses serious risks such as premature birth, low birth weight, stillbirth, neonatal death, deformed bones, anemia, enlarged liver and spleen, permanent vision or hearing loss, and meningitis. Alarmingly, the United States Centers for Disease Control and Prevention (CDC) has reported that congenital syphilis cases in the United States surged from 334 in 2012 to 3882 in 2023, including 279 stillbirths and infant deaths—the highest reported since 1992 (1). Fortunately, congenital syphilis is highly preventable through timely screening and treatment (2). In 2018, the U.S. Preventive Services Task Force (USPSTF) reviewed the available evidence and issued an “A” grade recommendation for universal syphilis screening in asymptomatic pregnant individuals (3). In 2025, the USPSTF reaffirmed this recommendation, concluding with high certainty that early screening provides a substantial net benefit. USPSTF advises early and universal screening for all pregnant individuals—adolescents and adults—regardless of risk factors. If early screening is missed, it should be performed at the next available opportunity, including at the time of delivery (4).