Screening for Syphilis Infection During Pregnancy

Importance Untreated syphilis infection during pregnancy can be passed to the fetus, causing congenital syphilis. Congenital syphilis is associated with premature birth, low birth weight, stillbirth, neonatal death, and significant abnormalities in the infant such as deformed bones, anemia, enlarged liver and spleen, jaundice, brain and nerve problems (eg, permanent vision or hearing loss), and meningitis. In 2023, there were 3882 cases of congenital syphilis in the US, including 279 congenital syphilis–related stillbirths and neonatal/infant deaths, the highest number reported in more than 30 years. Objective The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update focused on the benefits and harms of screening for syphilis infection in pregnancy. Population Adolescents and adults who are pregnant. Evidence Assessment The USPSTF concludes with high certainty that screening for syphilis infection in pregnancy has a substantial net benefit. Recommendation The USPSTF recommends early, universal screening for syphilis infection during pregnancy; if an individual is not screened early in pregnancy, the USPSTF recommends screening at the first available opportunity. (A recommendation)