Rising syphilis cases prompt more testing during pregnancy

June 3, 2024
When found and treated early with antibiotics, syphilis is curable.

Syphilis numbers are on the rise in Tennessee: In women, the number of cases has risen 311%, from 290 cases in 2017 to 1,191 in 2022. 

“Part of the issue is the lack of timely testing in pregnancy and adequate treatment during pregnancy,” said Soha Patel, MD, MSPH, assistant professor in the department of Obstetrics and Gynecology. “Another issue is regarding the shortage of the first line injectable penicillin for treatment of syphilis.” 

According to the Tennessee Department of Health, syphilis increases risk of preterm birth and is a major cause of stillbirth: Up to 40% of babies of mothers with untreated syphilis are stillborn or die in infancy. 

The American College of Obstetrician and Gynecologists (ACOG) updated their guidance — which previously recommended third trimester testing only for those in communities with high syphilis rates or have been at risk during pregnancy — to three screenings for every pregnant person. 

VUMC is in alignment with these recommendations and has rolled out the new requirement in inpatient and outpatient settings. 

“Timely diagnosis and treatment are key to reducing syphilis rates, and yet we are currently facing several challenges, including treatment shortages, lack of access to prenatal care, and the stigma that surrounds sexually transmitted infections,” said Christopher Zahn, MD, FACOG, interim ACOG CEO and chief of clinical practice and health equity and quality. “Congenital syphilis can have devastating effects. We know that a majority of cases can be prevented, so additional routine screening during pregnancy is one important step that clinicians can take that could potentially be lifesaving.” 

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