Maternal Syphilis Rate Surges 28% in Two Years: CDC Reports Continued US Epidemic

How Bad Is the Maternal Syphilis Epidemic in the US?

The CDC's National Center for Health Statistics published data showing a relentless acceleration of maternal syphilis in the United States. The rate rose 16% from 2022 (280.4 per 100,000 live births) to 2023 (324.6), then another 10% to 2024 (357.9). Viewed over the longer term, the increase is even more alarming: the maternal syphilis rate has risen 310% from 87.2 per 100,000 births in 2016 to its current level.

Congenital syphilis — infection transmitted from mother to baby during pregnancy or delivery — has risen in parallel. The United States recorded the highest number of congenital syphilis cases since 1992 in 2023, with nearly 4,000 affected newborns. Congenital syphilis can cause stillbirth, neonatal death, bone deformities, neurological damage, and other severe consequences. The tragedy is that congenital syphilis is almost entirely preventable: a simple blood test during pregnancy can detect the infection, and treatment with penicillin is highly effective at preventing transmission to the baby.

The epidemic has spread geographically as well. While syphilis was once concentrated primarily in urban areas of the southern United States, increases are now being documented across all regions and in both urban and rural settings. States with historically low syphilis rates are seeing rapid increases, challenging the capacity of local public health departments that have limited experience managing syphilis outbreaks.

Why Are Racial Disparities So Pronounced?

The CDC data reveal profound racial and ethnic disparities in maternal syphilis rates. From 2022 to 2024, the rate rose 52% among American Indian and Alaska Native non-Hispanic women (from 1,410.5 to 2,145.4 per 100,000 births), 31% among Hispanic women (313.8 to 411.1), 30% among Black non-Hispanic women (684.7 to 887.6), and 23% among White non-Hispanic women (152.8 to 188.2). American Indian and Alaska Native women now face maternal syphilis rates more than 11 times higher than white women.

These disparities reflect deep-rooted inequities in healthcare access. Many of the communities most affected by syphilis face shortages of prenatal care providers, maternity care deserts where hospitals have closed obstetric units, limited access to sexual health services, and barriers to obtaining timely treatment even after diagnosis. In many rural and tribal communities, the nearest health facility capable of providing comprehensive prenatal care may be hours away.

Decades of underfunding of sexually transmitted infection (STI) prevention infrastructure at the federal, state, and local levels have left public health departments ill-equipped to respond. Disease intervention specialists — the frontline workers who conduct partner notification, ensure patients complete treatment, and connect individuals to care — have been decimated by budget cuts. Recent federal funding reductions to public health agencies threaten to further weaken the response at a time when the epidemic is accelerating.

What Needs to Happen to Reverse This Trend?

Public health experts and medical organizations have outlined clear steps needed to reverse the maternal syphilis epidemic. The most immediate intervention is ensuring that all pregnant women receive syphilis screening at their first prenatal visit, with repeat screening in the third trimester and at delivery for those at elevated risk. Many states have updated their screening laws, but implementation remains inconsistent. Point-of-care rapid syphilis tests that deliver results in minutes can enable same-visit diagnosis and treatment, reducing the number of patients lost to follow-up.

Treatment itself is straightforward and inexpensive. A single injection of benzathine penicillin G cures early-stage syphilis and prevents congenital transmission. However, recurring shortages of injectable penicillin — the only recommended treatment for syphilis in pregnancy — have complicated treatment efforts. Ensuring stable supply chains for this essential medication is critical.

Longer-term solutions require addressing the structural factors driving the epidemic: expanding access to prenatal care, particularly in rural and underserved communities; restoring funding for STI prevention programs and disease intervention specialist positions; integrating syphilis screening into non-traditional healthcare settings such as emergency departments, substance use treatment programs, and community health centers; and reducing stigma that prevents individuals from seeking testing and treatment.