As syphilis cases among US newborns soar, doctors group advises more screening during pregnancy


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With syphilis cases in US newborns skyrocketing, a doctors group now recommends that all pregnant patients be screened three times for the sexually transmitted infection.

The American College of Obstetricians and Gynecologists issued new guidance on Thursday saying the screening should be done at the first prenatal visit, during the third trimester and at birth. Although the screening isn’t required, health professionals generally follow the group’s recommendations.

“The cases of congenital syphilis are definitely climbing, and they’ve been climbing over the last 10 years. And it’s completely preventable … It’s unacceptable,” said Dr. Laura Riley, who chairs the Department of Obstetrics and Gynecology at Weill Cornell Medicine and helped with the guidance. “We need to be able to do better diagnostics and treatment.”

Previously, the group recommended one test in the third trimester—but only for women considered at risk of getting syphilis during pregnancy or those living in communities with high rates of the disease. But this risk-based approach is “how we get into trouble because we’re missing cases,” Riley said.

Earlier this year, the Centers for Disease Control and Prevention said more than 3,700 babies were born with congenital syphilis in 2022, the most in more than 30 years. US health officials called for stepping up prevention, including screening which is done with a blood test.

In its advisory, the OB-GYN group said CDC statistics show nearly 9 in 10 congenital syphilis cases that year “could have been prevented with timely screening and treatment.”

Infections during pregnancy are generally treated with at least two doses of penicillin. Babies born to women with untreated syphilis may be stillborn or die shortly after birth. The disease can also cause other problems in newborns, such as deformed bones, severe anemia, blindness or deafness.

“I hope that everyone takes it seriously,” Riley said. Kids with congenital syphilis may have birth defects that can be devastating—”which is incredibly sad.”

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