Lehman Alice, Olson Nehemiah, Foster Jill, Contag Stephen
University of Minnesota Medical School Duluth.
Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota.
Sex Transm Dis. 2025 Apr 1;52(4):217-224. doi: 10.1097/OLQ.0000000000002093. Epub 2024 Nov 5.
Over the past 2 decades, congenital syphilis cases have risen 11-fold in the United States. Although disparities across geography, race, and ethnicity exist, lack of timely screening or treatment is identified in 88% of cases nationally. Congenital syphilis is a public health and medical problem rooted in systematic and societal structural determinants of health and health care limitations. Early syphilis in pregnancy leads to congenital syphilis if untreated in 50% to 70% of cases, with risk for fetal demise, and among survivors, congenital anomalies, organ damage, and central nervous system disease. Prevention of congenital syphilis lies in early detection and treatment in pregnant persons. In this narrative review, we describe the evolving epidemiology of syphilis and congenital syphilis, highlighting unique aspects among women. We explore the role of novel screening and treatment strategies, public health policy, and medical considerations in terms of congenital syphilis prevention. Readers of this review will understand congenital syphilis as a complex public health and medical disease that can be prevented through innovative and coordinated strategies in public health policy, expanded screening, and research opportunities.
在过去20年里，美国先天性梅毒病例增加了11倍。尽管在地理、种族和族裔方面存在差异，但全国88%的病例被发现存在筛查或治疗不及时的情况。先天性梅毒是一个公共卫生和医学问题，其根源在于健康和医疗保健限制的系统性及社会结构决定因素。孕期早期梅毒若不治疗，50%至70%的病例会导致先天性梅毒，存在胎儿死亡风险，而在存活者中，则有先天性异常、器官损害和中枢神经系统疾病的风险。先天性梅毒的预防在于对孕妇进行早期检测和治疗。在这篇叙述性综述中，我们描述了梅毒和先天性梅毒不断演变的流行病学情况，突出了女性中的独特方面。我们探讨了新型筛查和治疗策略、公共卫生政策以及先天性梅毒预防方面的医学考量。本综述的读者将把先天性梅毒理解为一种复杂的公共卫生和医学疾病，可通过公共卫生政策方面的创新与协调策略、扩大筛查以及研究机会来预防。
