Congenital syphilis is on the rise: What pregnant women need to know

Reasons for this exponential rise are complex. Limited access to preventive and prenatal care are factors driving the surge in congenital syphilis cases, along with other social determinants of health and substance use disorders as well as public awareness and public health funding gaps. The pandemic took a dramatic toll on public health, and many patients who lost jobs and income were left without health insurance and a direct link to health education. Discussing STIs can be uncomfortable for patients and their partners. But getting screened regularly – particularly with a new sexual partner and after unprotected sex – and seeking prenatal care as soon as pregnancy is suspected offers the best chance of healthier outcomes for the mother and baby. Screening for sexually transmitted infections is often free and can be accessed through primary care, prenatal care, or through sexual health clinics. How is congenital syphilis diagnosed? Congenital syphilis is a consequence of maternal syphilis, which is an infection that comes from sexual contact with an infected partner. Syphilis is often called “the great imitator” because its symptoms often mimic those of other diseases, although most infections do not cause noticeable symptoms at all. The only way to know for sure is to get a syphilis test, which involves a simple blood draw. Some signs the mother or her partner may be infected include: Firm, round, sores on mucosal surfaces like genital area or mouth Skin rashes over the torso, hands, or feet Bumps or growths in the genital area Swollen lymph nodes Fever, malaise, and fatigue Hair loss in patches If a pregnant woman is diagnosed with syphilis in the second or third trimester, we will use ultrasound to examine the fetus for signs of congenital syphilis, such as: Enlarged liver Enlarged placenta Signs of anemia Signs of heart failure Fluid in the abdominal cavity After birth, pediatric specialists make a diagnosis of congenital syphilis after a thorough evaluation of the baby. This evaluation may include physical examination, laboratory tests, radiologic studies (X-rays), and sometimes more invasive tests like lumbar puncture (spinal tap).