How to protect your baby from the effects of this common infection.
Syphilis is a sexually transmitted infection that can pass from mother to baby during pregnancy. When a baby is born with the infection, it’s referred to as congenital syphilis. Rates of congenital syphilis are increasing, across the U.S. and within Tennessee.
While cases of congenital syphilis rose 185% nationally between 2017 and 2021, Tennessee saw an even larger increase. During the same time period, the number of cases in this state nearly quadrupled (10 cases in 2017, rising to 38 in 2021). They’ve continued to rise: In 2023, there were 89 cases of babies born infected with syphilis in Tennessee.
Risks to mother and baby
Untreated, this infection can lead to devastating results.
“In very advanced stage syphilis, it can actually cause cardiovascular infection and affect the nervous system, eyes and more.”
“Syphilis can cause a wide range of symptoms for the mom, depending on which stage it is in,” said Dr. Soha S. Patel, a Vanderbilt Health maternal-fetal medicine physician specializing in high-risk pregnancy care. “It can cause systemic infection, leading to skin rash, fever, enlarged lymph nodes, etc., during the second stage. In very advanced stage syphilis, it can actually cause cardiovascular infection and affect the nervous system, eyes and more.”
It can have catastrophic effects on baby and the pregnancy as well. Congenital syphilis can cause:
- Miscarriage
- Stillbirth
- Infant death
- Premature birth
- Low birth weight
Babies born with this infection can have or develop:
- Anemia
- Birth defects
- Brain and nerve problems, including blindness or deafness
- Jaundice (yellowing of the skin or eyes)
- Meningitis
- Skin rashes
New screening recommendations
Treating syphilis during pregnancy can prevent the above symptoms, allowing mom to have a healthy pregnancy and baby. But first, the infection must be detected, which is often the most difficult part, considering many of these infections during pregnancy are latent, or without symptoms. Because of this, and the increasing frequency of congenital syphilis, in 2024 the American College of Obstetricians and Gynecologists recommended new syphilis screening guidelines for pregnant women.
The updated guidelines say that pregnant patients should be checked for syphilis at the first prenatal appointment, sometime during the third trimester and again at birth. The screening test is done with a simple blood test.
“We’ve always screened individuals during the first prenatal visit,” said Patel. “It’s the second and third screenings for all pregnant individuals that are new. We’re hoping this will reduce congenital syphilis infections across our state.”
Treatment is effective for syphilis
If syphilis is detected at any point during pregnancy, a course of penicillin G will be prescribed.
“This is the only recommended treatment for syphilis during pregnancy,” said Patel. “It’s about 98% to 99% effective in treating maternal infection and preventing congenital syphilis.”
Preventing reinfection
It is possible to become reinfected with syphilis, so it’s important for pregnant people to practice safer sex even after being treated.
“One of the biggest mainstays of treatment is not only treating the patient, but also the treatment of her partner,” said Patel. “Obviously, that’s a complex topic in and of itself, but we can help women through it.”
If your pregnancy is considered high risk
Vanderbilt Health’s high-risk obstetrics team, known as maternal-fetal medicine (MFM) specialists, provides the region’s most advanced care for you and your little one. Two specialized teams offer excellent care: One team for you, and one dedicated to your baby (or babies). They work closely with your regular obstetrician to reduce delivery complications.
