Congenital Syphilis

Syphilis is a sexually transmitted infection that can lead to serious health problems if left untreated. Symptoms can range from a rash, open sores, flu-like symptoms, or complications resulting in damage to major organs. Syphilis in pregnant women is of great concern. An infected mother can pass syphilis to her baby during pregnancy. Congenital syphilis can lead to stillbirth, pre-term delivery, and other congenital abnormalities in the newborn including severe damage to bones, brain, lungs, liver, and other organs.

Arkansas is facing a substantial increase in congenital syphilis cases. According to the Arkansas Department of Health, from 2017 to 2023, reported cases have surged nearly five times, from 13 to 64. Tragically, during this period, 23 infants died due to congenital syphilis. Additionally, the state ranks 4th nationally in primary and secondary syphilis rates, with 896 cases reported in 2023. Alarmingly, approximately 50% of congenital syphilis cases are linked to inadequate or delayed maternal testing and treatment.

Congenital syphilis is preventable. Early maternal detection and treatment of syphilis prior to delivery are vital. Arkansas is aiming to reduce congenital syphilis rates through a comprehensive outreach approach focusing on prevention, early detection, and treatment. AFMC’s Medicaid Quality Improvement (MQI) team, contracted by Arkansas Medicaid, is implementing a quality improvement project providing guidance to all Arkansas providers who serve pregnant women to meet American College of Obstetricians and Gynecologists (ACOG) recommendations for syphilis screening. In 2024, the American College of Obstetricians and Gynecologists (ACOG) issued a new ACOG Practice Advisory that recommends universal syphilis screening for all pregnant women at the first prenatal care visit, during the third trimester, and again when a pregnant woman arrives to give birth.

ACOG strongly encourages providers to implement standardized processes to ensure that all pregnant women are counseled and offered syphilis screening at the three recommended intervals. At times it may be necessary to screen pregnant women at healthcare encounters outside of routine prenatal and delivery care, including visits to the emergency department and labor & delivery triage. Per Arkansas Medicaid policy, claims with specific primary diagnoses, including pregnancy, are exempt from laboratory service benefit limits.

Our Congenital Syphilis Screening and Prevention Project supports healthcare providers in:

• Early Screening & Detection of Syphilis: Screen all pregnant women for syphilis at the first prenatal visit, during the third trimester, and at delivery.
• Prompt Treatment of Pregnant Women and their Partner(s): Initiate immediate treatment for positive cases to prevent transmission to the baby and prevent the pregnant woman from becoming re-infected. 
• Newborn Evaluation and Treatment: Assess and treat infants at risk for congenital syphilis promptly to prevent severe health complications.

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