A Rising Threat to Pregnant Women: Syphilis

Syphilis continues to make a dismaying comeback in the United States.

Between 2012 and 2016, the rate of primary and secondary syphilis among women increased 111 percent. Over the same period, the rate of congenital syphilis increased by 87 percent.

The sexually transmitted disease is caused by infection with the bacterium Treponema pallidum. The bacterium also can be passed from mother to child during pregnancy or birth.

Up to 40 percent of infants with syphilis are stillborn. The rest appear normal at birth; if left untreated, however, they may develop a number of serious symptoms, from bone pain to deafness and blindness.

Infected babies are treated with penicillin. Infants who picked up the bacterium while passing through the birth canal generally fare better than those infected during pregnancy.

The C.D.C. recommends screening at the first prenatal visit. Because some women become infected after the initial test, women should be screened again during the third trimester and again at delivery, especially those women living where prevalence is high.

Treatment of pregnant women with penicillin is up to 98 percent effective in preventing congenital syphilis.

“The incidence of syphilis has been at an all-time low over the past 20 years,” Dr. Kidd said. “Some recently trained physicians have never seen it. But it’s making a comeback, and physicians should be aware of it.”

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