USPSTF Reaffirms Syphilis Screening for Pregnant Individuals Amid Rising Congenital Syphilis Rates

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The US Preventive Services Task Force (USPSTF) released a draft recommendation encouraging physicians to screen for syphilis in people who are pregnant as early as possible.

The recommendation is graded “A,” consistent with the USPSTF’s 2018 recommendation on the topic.

“Cases of congenital syphilis are 10 times higher now than they were a decade ago,” USPSTF member Carlos Jaén, MD, PhD, MS, the Dr. and Mrs. James L. Holly distinguished chair in the department of family and community medicine at the Joe R. and Teresa Lozano Long School of Medicine at The University of Texas Health Science Center at San Antonio, said in a press release. “Fortunately, screening for syphilis early in pregnancy is an effective way to identify the infection so it can be treated, improving the health of both the pregnant person and their baby.”

According to the latest CDC data, rates of congenital syphilis increased 2.9% between 2022 and 2023, rising from 102.8 cases per 100 000 live births to 105.8 cases per 100 000 live births. The USPSTF noted that untreated congenital syphilis can result in serious health complications, such as premature birth and hearing or vision loss.

In its evidence review, task force members examined studies published since 2017 on the benefits and harms of screening for syphilis in people who are pregnant. The expert panel did not identify any new studies examining the effectiveness of syphilis screening.

The USPSTF concluded that the evidence remained consistent with prior reviews on syphilis screening and “supports the need for two-step serologic screening to reduce false screening results.”

The task force emphasized that pregnant individuals should be screened as early as possible, such as at their first prenatal visit or the first time they see a health care professional during their pregnancy. The USPSTF also stressed that individuals who screen positive must receive evidence-based evaluation and treatment.

Black, Hispanic, and Native American/Alaska Native people who are pregnant are disproportionally affected by the infection, being eight times more likely to have babies with congenital syphilis, according to the USPSTF press release. The task force attributed these disparities to structural and social factors that affect health care behaviors and access and called for further research on ways to reduce these disparities.

“Almost 90% of cases of congenital syphilis could have been prevented with timely testing and treatment,” USPSTF vice chair Michael Silverstein, MD, MPH, the George Hazard Crooker University professor of health services, policy, and practice at the Brown University School of Public Health and the director of Brown University’s Hassenfeld Child Health Innovation Institute, said in the release. “It is essential to address barriers to care to ensure that all pregnant people get screened and those who screen positive receive timely, equitable and evidence-based care.”

Comments on the draft recommendation can be submitted here from November 19 through December 23, 2024.

Reference: US Preventive Services Task Force issues draft recommendation statement on screening for syphilis in pregnancy. News release. USPSTF. November 19, 2024. Accessed November 26, 2024. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/syphilis-pregnancy-draft-rec-bulletin.pdf