Fewer than half of people who gave birth to infants with congenital syphilis received any prenatal care, according to a new report from one county in Nevada. This lack of prenatal care resulted in a significant barrier to timely syphilis testing and treatment (MMWR Morb Mortal Wkly Rep 2025;74[20]:350-354).
“Congenital syphilis can result in severe infant morbidity and death,” said lead report author Jessica Penney, MD, a medical officer in the Division of STD Prevention at the CDC. “This report shows that lack of access to timely prenatal syphilis screening and treatment is a major barrier to preventing congenital syphilis in infants.”
43% Did Not Receive Prenatal Care
The study took place in Clark County, Nev., and used data from the Southern Nevada Health District from 2017 to 2022. The study included data from women of reproductive age (15-44 years of age) with confirmed or probable syphilis who had a liveborn or stillborn infant with congenital syphilis.
Among a total of 195 identified individuals, most mothers (85%) with diagnosed syphilis who delivered infants without congenital syphilis received prenatal care. Mothers who delivered an infant with congenital syphilis were far less likely to have received prenatal care (43%).
Although half of the women who had infants with congenital syphilis visited an emergency department (ED) while pregnant, one in three of these women did not get tested for syphilis.
“For many of these mothers, this ED visit may have been the only point of prenatal care they had access to during their pregnancy and was a missed opportunity to potentially prevent congenital syphilis,” Dr. Penney said. “Complicating life experiences such as substance use, limited access to care and homelessness can serve as barriers to prenatal care.
“While Nevada law requires that providers screen pregnant women for syphilis multiple times throughout pregnancy, not all women may access routine prenatal care,” Dr. Penney added.
Reaching Patients Outside of Obstetrics
The report determined that healthcare encounters in nontraditional care settings—like the ED—could provide an opportunity for syphilis screening of pregnant people who do not access prenatal care. Such encounters, the authors noted, might help prevent congenital syphilis. (Recently, the United States Preventative Service Task Force updated their guidelines, including screening recommendations.)
“CDC is urgently encouraging public health leaders and any healthcare provider with pregnant or reproductive-age patients to provide syphilis testing and treatment during pregnancy in alternative settings, such as emergency departments, syringe service programs, prisons/jails, maternal and child health programs,” Dr. Penney said. “Timely identification and treatment of pregnant women with syphilis is critical for the health of pregnant women and their babies. All healthcare during pregnancy is prenatal care and is an opportunity for syphilis screening and prompt treatment to prevent congenital syphilis.”
Dr. Penney reported no relevant financial disclosures.
