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Syphilis and pregnancy

pregnant women in group

What is Congenital Syphilis?

Syphilis in newborns is known as Congenital Syphilis (CS). Syphilis can be passed to a baby during pregnancy or at delivery if the mother has untreated syphilis.

CS can lead to miscarriage, stillbirth, preterm delivery, birth defects, and even infant death. Some infants with CS can be asymptomatic and healthy at birth, but develop life-altering complications later in life. 


Congenital Syphilis in Colorado


What Can I Do to Protect Myself and my Baby?

  • Make sure to request a comprehensive sexually transmitted infection (STI) test panel screening at your first prenatal visit. This panel includes syphilis testing.
  • If you test positive for syphilis, get treatment right away.
  • If you are pregnant, and have syphilis, you can still reduce the risks of passing syphilis to your baby. Getting tested and treated for syphilis can prevent serious health complications for both you and your baby
  • Prenatal care is essential to the overall health and wellness of you and your unborn child. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby.
  • Talk to your partner(s) about getting tested.
  • Use condoms during sexual intercourse.
  • Remember that it’s possible to get syphilis and not know it, because sometimes the infection causes no symptoms, only very mild symptoms, or symptoms that mimic other illnesses.
  • Talk with your doctor about your risk for syphilis. Have an open and honest conversation about your sexual history and STI testing. Your doctor can give you the best advice on any testing and treatment that you may need. 

Syphilis Testing and the Law

Colorado law requires syphilis testing for all persons at their first prenatal visit. CDC recommends third trimester testing at 28 weeks’ gestation and again at delivery for select individuals, including those:

  • Living in a community with high syphilis morbidity; Or
  • Is at heightened risk for syphilis acquisition during pregnancy 
    • Recent history of syphilis, living with HIV, STI diagnosis in the past 12 months, Illicit substance use, sex exchange, multiple partner, or partner with other partners. 

Additionally, CDC recommends syphilis testing for all persons who deliver a stillborn at or greater than 20 weeks’ gestation.


Treatment for Syphilis in Pregnancy

Persons with a syphilis diagnosis should seek treatment as soon as possible –especially if they are pregnant – to prevent serious complications to their baby. Long-acting benzathine penicillin G therapy must be used to treat syphilis during pregnancy to prevent syphilis transmission to the infant. This therapy is extremely effective in preventing CS, with a success rate of up to 98 percent. Persons who are allergic to penicillin should see a specialist for desensitization to penicillin.

Women diagnosed with late syphilis of unknown duration require three doses of benzathine penicillin G given one week apart; if doses are missed or given more than nine days apart, treatment must be restarted. Failure to initiate and complete appropriate syphilis treatment at least 30 days prior to delivery will result in a reported CS case.
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