The maternal syphilis rate in the United States rose 28% from 2022 to 2024, according to a new analysis from the National Center for Health Statistics (NCHS). The rising rate underscores the scope of a worsening public health crisis that has seen maternal syphilis rates climb more than 200% over the past decade.
The latest report finds that the maternal syphilis rate increased 16% from 2022 to 2023 and an additional 10% from 2023 to 2024, rising from 280.4 to 357.9 cases per 100,000 births over the two-year period. The increase follows a previously documented 222% surge from 2016 to 2022, when the rate climbed from 87.2 to 280.4 per 100,000 births.
Rates of maternal syphilis have been rising for decades, and the surge is fueling a parallel crisis in rates of congenital syphilis, which is when a pregnant woman with untreated syphilis passes the infection to her fetus. Associated with fetal and neonatal death (the infection kills as many as 40% of infected infants), low birthweight, preterm birth, and brain and nerve disorders, congenital syphilis is almost entirely preventable with routine screening in early pregnancy and treatment with penicillin.
In 2023, the United States recorded the most congenital syphilis cases since 1992. Global estimates suggest that maternal syphilis may cause as many as 350,000 adverse birth outcomes every year, and research indicates that kids 5 years and younger who are exposed to maternal syphilis in utero are at higher risk for all-cause hospitalization and experience longer hospital stays than unexposed kids.
Racial, ethnic, regional disparities in rising rates
Racial and ethnic disparities in maternal syphilis rates are pronounced. From 2022 to 2024, rates increased 52% among American Indian and Alaska Native mothers, rising from 1,410.5 to 2,145.4 per 100,000 births. Rates also rose 31% among Hispanic mothers, 30% among Black mothers, and 23% among White mothers over the same period.
Increases were also seen across all maternal age-groups. From 2022 to 2024, maternal syphilis rates rose 36% among mothers aged 35 to 39, 31% among those aged 40 and older, and 30% for mothers ages 30 to 34. Rates were slightly lower, but still high overall, among younger mothers, with a 29% increase for mothers ages 20 to 24, 26% for mothers ages 25 to 29, and 13% for mothers younger than age 20.
Some regions of the country have been hit especially hard. The rate of maternal syphilis infections in Mississippi grew more than 1,000% from 2013 to 2023, with case numbers climbing from 86 cases per 100,000 births to 1,016 cases per 100,000 births during that time. In August 2025, the state declared a public health emergency because of the spike in infant mortality rates.
Gaps in screening and treatment, penicillin shortage fuel rising rates
Twenty-five years ago, syphilis was nearly eradicated in the United States. Public health experts point to gaps in early prenatal screening and treatment as drivers of rising rates of congenital syphilis. From 2013 to 2023, for example, over one-third of pregnant women with syphilis in Mississippi had no first trimester prenatal care.
Across the United States, missed opportunities for testing and treatment during pregnancy contributed to nearly 90% of congenital syphilis cases in 2022. What’s more, the country is experiencing a nationwide shortage of injectable penicillin G benzathine, the only medication approved to treat syphilis in pregnant women.
“There is an ongoing need in the US to strengthen strategies to increase access to obstetrical care,” wrote Robert L. Cook, MD, MPH, professor of epidemiology at the University of Florida, in a commentary published in JAMA Network Open late last year. “New public health interventions and policies will continue to be needed in the US and worldwide to reduce adverse outcomes related to syphilis and other sexually transmitted infections during pregnancy.”
