Prenatal Syphilis Screening (PSY-E)

The percentage of deliveries that had a syphilis screening during the first trimester or within 14 days of the first pregnancy diagnosis or prenatal visit or within 30 days of enrollment in the organization.

Why It Matters

The prevalence of congenital syphilis (CS) has been increasing in the United States despite evidence, guideline recommendations and state policies that promote syphilis screening during pregnancy to prevent transmission (1, 2, 3). If untreated, syphilis acquired at any point prior to or during pregnancy can lead to CS in newborns, with a transmission frequency of up to 90% (4). CS can cause severe issues throughout a newborn’s body, including jaundice, skin/organ lesions, skeletal deformities, and respiratory issues. More severe consequences such as sensory impairments, brain abnormalities and seizures are possible as well (5, 6).

Syphilis infection in pregnant individuals is strongly associated with preterm birth, miscarriage, stillbirths, and drives adverse population health outcomes such as neonatal mortality and a loss of lifetime Quality-Adjusted Life Years (7, 8, 9, 10, 11).

Developed with financial support from the National Association of County and City Health Officials and funding from the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.

Historical Results – National Averages

Performance results for this measure are currently unavailable.

References

  1. American College of Obstetricians and Gynecologists. 2024. “Screening for Syphilis in Pregnancy: Practice Advisory.” Screening for Syphilis in Pregnancy. April 2024. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2024/04/screening-for-syphilis-in-pregnancy
  2. S. Preventive Services Task Force. 2025. “Syphilis Infection During Pregnancy: Screening.” U.S. Preventive Services Task Force. Accessed July 15, 2026. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-in-pregnancy-screening.
  3. Centers for Disease Control and Prevention, Division of STI Prevention. 2021. “Syphilis During Pregnancy.” Sexually Transmitted Infections Treatment Guidelines, 2021. July 22, 2021. https://www.cdc.gov/std/treatment-guidelines/syphilis-pregnancy.htm
  4. Pérez-Cavazos, Samantha, María Mayela Rodríguez-Saldívar, Abiel Homero Mascareñas-De los Santos, and José Iván Castillo-Bejarano. “Congenital Syphilis: The Irrevocable Burden of a Late Diagnosis.” Pediatrics & Neonatology 63 (3): 306–7. https://doi.org/10.1016/j.pedneo.2021.10.00
  5. Lim, Joohee, So Jin Yoon, Jeong Eun Shin, Jung Ho Han, Soon Min Lee, Ho Seon Eun, Min Soo Park, and Kook In Park. 2021. “Outcomes of Infants Born to Pregnant Women with Syphilis: A Nationwide Study in Korea.” BMC Pediatrics 21 (47). https://doi.org/10.1186/s12887-021-02502-9.
  6. Pañgan, Erika Anne C., Imelda Asetre-Luna, Maria Esterlita V. Uy, and Angela Katrina M. Esguerra. “Pemphigus Syphiliticus with Jarisch–Herxheimer Reaction in a Newborn.” Pediatric Dermatology 41 (1): 153–55. https://doi.org/10.1111/pde.15428
  7. Canto, Surama Valena Elarrat, Maria Alix Leite Araújo, Angélica Espinosa Miranda, Ana Rita Paulo Cardoso, and Rosa Lívia Freitas de Almeida. “Fetal and Infant Mortality of Congenital Syphilis Reported to the Health Information System.” PLOS ONE 14 (1): e0209906. https://doi.org/10.1371/journal.pone.0209906.
  8. Gulersen, Moti, Erez Lenchner, Yael Eliner, Amos Grunebaum, Lisa Johnson, Frank A. Chervenak, and Eran Bornstein. 2023. “Risk Factors and Adverse Outcomes Associated with Syphilis Infection during Pregnancy.” American Journal of Obstetrics & Gynecology MFM 5 (6). https://doi.org/10.1016/j.ajogmf.2023.100957.
  9. Lee, Kyueun, Shiying You, Yunfei Li, Harrell Chesson, Thomas L Gift, Andrés A Berruti, Katherine Hsu, Reza Yaesoubi, Joshua A Salomon, and Minttu Rönn. 2023. “Estimation of the Lifetime Quality-Adjusted Life Years (QALYs) Lost Due to Syphilis Acquired in the United States in 2018.” Clinical Infectious Diseases 76 (3): e810–19. https://doi.org/10.1093/cid/ciac427.
  10. Schlueter, Alison, Uma Doshi, Bharti Garg, Alyssa R. Hersh, and Aaron B. Caughey. 2021. “Adverse Pregnancy Outcomes Associated with Maternal Syphilis Infection.” The Journal of Maternal-Fetal & Neonatal Medicine 35 (25): 5828–33. https://doi.org/10.1080/14767058.2021.1895740.
  11. Tong, Hannah, Austin Heuer, and Neff Walker. 2023. “The Impact of Antibiotic Treatment for Syphilis, Chlamydia, and Gonorrhoea during Pregnancy on Birth Outcomes: A Systematic Review and Meta-Analysis.” Journal of Global Health 2023 (13): 04058.

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