The maternal syphilis price in the US rose 28% from 2022 to 2024, in line with a brand new evaluation from the Nationwide Heart for Well being Statistics (NCHS). The rising price underscores the scope of a worsening public well being disaster that has seen maternal syphilis charges climb greater than 200% over the previous decade.
The newest report finds that the maternal syphilis price elevated 16% from 2022 to 2023 and an extra 10% from 2023 to 2024, rising from 280.4 to 357.9 instances per 100,000 births over the two-year interval. The rise follows a beforehand documented 222% surge from 2016 to 2022, when the speed climbed from 87.2 to 280.4 per 100,000 births.
Charges of maternal syphilis have been rising for many years, and the surge is fueling a parallel disaster in charges of congenital syphilis, which is when a pregnant lady with untreated syphilis passes the an infection to her fetus. Related to fetal and neonatal loss of life (the an infection kills as many as 40% of contaminated infants), low birthweight, preterm beginning, and mind and nerve problems, congenital syphilis is sort of solely preventable with routine screening in early being pregnant and remedy with penicillin.
In 2023, the US recorded probably the most congenital syphilis instances since 1992. International estimates recommend that maternal syphilis might trigger as many as 350,000 opposed beginning outcomes yearly, and analysis signifies that children 5 years and youthful who’re uncovered to maternal syphilis in utero are at greater danger for all-cause hospitalization and expertise longer hospital stays than unexposed children.
Racial, ethnic, regional disparities in rising charges
Racial and ethnic disparities in maternal syphilis charges are pronounced. From 2022 to 2024, charges elevated 52% amongst American Indian and Alaska Native moms, rising from 1,410.5 to 2,145.4 per 100,000 births. Charges additionally rose 31% amongst Hispanic moms, 30% amongst Black moms, and 23% amongst White moms over the identical interval.
Will increase have been additionally seen throughout all maternal age-groups. From 2022 to 2024, maternal syphilis charges rose 36% amongst moms aged 35 to 39, 31% amongst these aged 40 and older, and 30% for moms ages 30 to 34. Charges have been barely decrease, however nonetheless excessive general, amongst youthful moms, with a 29% enhance for moms ages 20 to 24, 26% for moms ages 25 to 29, and 13% for moms youthful than age 20.
Some areas of the nation have been hit particularly exhausting. The speed of maternal syphilis infections in Mississippi grew greater than 1,000% from 2013 to 2023, with case numbers climbing from 86 instances per 100,000 births to 1,016 instances per 100,000 births throughout that point. In August 2025, the state declared a public well being emergency due to the spike in toddler mortality charges.
Gaps in screening and remedy, penicillin scarcity gas rising charges
Twenty-five years in the past, syphilis was almost eradicated in the US. Public well being specialists level to gaps in early prenatal screening and remedy as drivers of rising charges of congenital syphilis. From 2013 to 2023, for instance, over one-third of pregnant girls with syphilis in Mississippi had no first trimester prenatal care.
Throughout the US, missed alternatives for testing and remedy throughout being pregnant contributed to just about 90% of congenital syphilis instances in 2022. What’s extra, the nation is experiencing a nationwide scarcity of injectable penicillin G benzathine, the one remedy accredited to deal with syphilis in pregnant girls.
“There may be an ongoing want within the US to strengthen methods to extend entry to obstetrical care,” wrote Robert L. Prepare dinner, MD, MPH, professor of epidemiology on the College of Florida, in a commentary printed in JAMA Community Open late final yr. “New public well being interventions and insurance policies will proceed to be wanted within the US and worldwide to cut back opposed outcomes associated to syphilis and different sexually transmitted infections throughout being pregnant.”
