Congenital Syphilis in California

California

Congenital syphilis is a preventable infection passed from a pregnant person with syphilis to their baby during pregnancy. The bacteria Treponema pallidum causes congenital syphilis and can be transmitted during either fetal development or birth. The number of congenital syphilis cases in the U.S. has increased in recent years, with over 3,700 cases reported in 2022 and more than 10 times the number of babies born with syphilis than in 2012. 

Complications from congenital syphilis during pregnancy include miscarriage, preterm birth and stillbirth. It can also cause neonatal death, anemia or meningitis. Untreated congenital syphilis can lead to health issues later in life as well, such as developmental delays and problems with vision, hearing, bones or joints

There are financial impacts as well. Hospitalizations from congenital syphilis cost an average of $58,500 in comparison with the average of $12,600 per infant hospitalization for other conditions.

The prevalence of congenital syphilis is higher among:

• Infants born to American Indian/Alaska Native mothers compared with infants born to non-Hispanic white and Asian mothers.
• Infants born in the South compared with those born in the Northeast.
• Medicaid beneficiaries compared with patients who have private insurance.

Additionally, the Centers for Disease Control and Prevention (CDC) found that more than 37% of infants with congenital syphilis were born to individuals who did not receive any prenatal care in 2022.

Lack of timely testing and adequate treatment for syphilis is contributing to increased rates of congenital syphilis. The American College of Obstetricians and Gynecologists recommends that health care professionals screen all pregnant persons for syphilis at the first prenatal care visit, followed by rescreening during the third trimester and at birth.

The CDC recommends reducing the risk of getting syphilis before and during pregnancy by using condoms and making sure your partner has been tested for syphilis and other sexually transmitted infections. The CDC also has specific recommendations for health care providers on how to evaluate and treat babies born to people who have positive syphilis tests during pregnancy.

The Association of State and Territorial Health Officials has released a report that presents strategies in different policy areas to address the rising rates of congenital syphilis, including strengthening prenatal syphilis screening policies and requirements, establishing Fetal Infant Morbidity Review boards, providing better care to pregnant people experiencing substance use and expanding Medicaid coverage.

Healthy People 2030 has an objective to decrease the rate of congenital syphilis. 

LeBlanc, Michelle. “Congenital Syphilis.” Issue Brief. National Governors Association, January 2024. https://www.nga.org/wp-content/uploads/2024/01/CS_IssueBrief_Jan2024.pdf.

Leslie, Stephen W., and Ruben Vaidya. “Congenital and Maternal Syphilis.” In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2024. https://www.ncbi.nlm.nih.gov/books/NBK537087/.

McDonald, Robert, Kevin O’Callaghan, Elizabeth Torrone, Lindley Barbee, Jeremy Grey, David Jackson, Kate Woodworth, et al. “Vital Signs: Missed Opportunities for Preventing Congenital Syphilis — United States, 2022.” MMWR. Morbidity and Mortality Weekly Report 72, no. 46 (November 17, 2023): 1269–74. https://doi.org/10.15585/mmwr.mm7246e1.

“Policy Considerations for Reducing Congenital Syphilis.” ASTHO, May 2023. https://www.astho.org/globalassets/report/policy-considerations-reducing-congenital-syphilis.pdf.

Tesini, Brenda L. “Congenital Syphilis.” In Merck Manual Professional Edition. Rahway, NJ: Merck & Co., Inc., 2022. https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/congenital-syphilis.