Syphilis in pregnancy

Syphilis in pregnancy refers to syphilis infection occurring during pregnancy, with particular relevance to prevention of fetal infection and congenital syphilis ^[2][3]. It is a treponemal infection caused by the spirochete *Treponema pallidum* and is described in the sources as a sexually transmitted infection that can also be acquired hematogenously or through vertical transmission ^[1][2]. The condition is framed in the literature as a public-health threat because maternal infection may result in transmission to the fetus and adverse pregnancy outcomes ^[1][2].

The cited sources describe pregnancy-associated syphilis as capable of causing serious maternal and neonatal complications, though detailed maternal symptom patterns are not provided in the source snippets ^[1]. For congenital infection, the reported outcomes include stillbirth, miscarriage, preterm birth, birth defects, and lifelong physical or neurologic changes ^[2]. Another source adds low birth weight and congenital syphilis among the possible outcomes of untreated infection in pregnancy ^[4]. The available material does not provide a source-backed clinical staging summary for pregnant patients beyond noting that clinical staging incorporates prior treatment history and physical examination ^[2].

The sources characterize syphilis in pregnancy and congenital syphilis as a re-emerging public-health concern rather than a static condition ^[1][2]. In the United States, congenital syphilis rates were reported to have reached a 30-year high in 2021, and one review states that rates increased by 261% from 2013 to 2018 and continued to rise in 2021 ^[1][2]. Globally, congenital syphilis is described as carrying a substantial burden, with incidence reported as rising particularly in low- and middle-income regions ^[3]. One review cites recent data of 473 cases per 100,000 live births and 661,000 total cases, including 355,000 adverse birth outcomes ^[3].

Syphilis can be acquired sexually, hematogenously, or via vertical transmission from mother to infant ^[2]. In pregnancy, the key public-health concern is transplacental or otherwise vertical transmission from an infected pregnant person to the fetus, which may occur if maternal infection is untreated ^[2][4]. One source notes that infectivity for sexual partners lasts for about a year from the moment of infection, while untreated pregnant women may transmit infection to the fetus within four years of infection ^[4].

The source material specifically identifies people of reproductive age as a population in which syphilis rates have increased, and this rise is associated with increasing congenital syphilis cases ^[1]. Pregnant women with untreated infection are a key risk group for fetal transmission and adverse birth outcomes ^[2][4]. The available snippets do not provide additional source-backed demographic or behavioral risk stratification beyond pregnancy status and reproductive age ^[1][2].

The sources emphasize prevention through antenatal screening and treatment of infected pregnant women, which is described as effective for preventing congenital syphilis ^[3]. One review states that the only recommended treatment in pregnancy is benzathine penicillin G, and that evidence for reduced congenital syphilis risk with other modalities is lacking ^[2]. Another source highlights the role of mandatory serological screening tests for all pregnant women as an approach to improving detection and prevention ^[4]. The available material does not provide a schedule for screening or a detailed prevention algorithm beyond these points ^[2][4][3].

For surveillance purposes, this condition should be read as a maternal infection marker with direct implications for congenital syphilis burden ^[1][2]. The cited literature links rising prevalence among people of reproductive age with increases in congenital syphilis, making pregnancy surveillance an important upstream indicator of neonatal risk ^[1]. The sources also frame congenital syphilis as a preventable outcome, so monitoring should focus on timely antenatal detection and treatment coverage where such data are available ^[3]. Source-backed detail on standardized case definitions beyond the provided ICD range is not yet available [disease metadata].

1. 1 d'Hemecourt K et al. Syphilis in Pregnancy and Congenital Syphilis. R I Med J (2013). 2024 Dec 2. PMID: 39576996. PubMed: https://pubmed.ncbi.nlm.nih.gov/39576996/
2. 2 Eppes CS et al. Syphilis in pregnancy: an ongoing public health threat. Am J Obstet Gynecol. 2022 Dec. PMID: 35932881. doi: 10.1016/j.ajog.2022.07.041. PubMed: https://pubmed.ncbi.nlm.nih.gov/35932881/
3. 3 Salomè S et al. Congenital Syphilis: A Re-Emerging but Preventable Infection. Pathogens. 2024 Jun 6. PMID: 38921779. doi: 10.3390/pathogens13060481. PubMed: https://pubmed.ncbi.nlm.nih.gov/38921779/
4. 4 Syphilis in pregnancy. Zdravstvena zastita. 2021. doi: 10.5937/zdravzast50-30653. DOI: https://doi.org/10.5937/zdravzast50-30653
5. 5 Syphilis Complicating Pregnancy and Congenital Syphilis. New England Journal of Medicine. 2024. doi: 10.1056/nejmc2401932. DOI: https://doi.org/10.1056/nejmc2401932
6. 6 Syphilis Complicating Pregnancy and Congenital Syphilis. New England Journal of Medicine. 2024. doi: 10.1056/nejmra2202762. DOI: https://doi.org/10.1056/nejmra2202762

ICD-10

A50-A53

ICD-11

Total cases

0

Peak month

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Coverage

0 reporting countries · —