How Health Plans Can Help Curb the Nationwide Increase in Congenital Syphilis

A growing number of babies in the United States are born with syphilis, which can either be fatal for the infant or cause lifelong medical issues, according to the Centers for Disease Control and Prevention (CDC). There were 10 times more cases in 2022 than in the decade prior -- 231 stillbirths and 51 infant deaths.

Syphilis is a sexually transmitted infection that can cause pregnancy complications. When passed on to a baby during pregnancy or childbirth, the disease is called congenital syphilis.

People infected with syphilis frequently don’t have symptoms and can unknowingly give the disease to their partner and baby—this is a main reason why rates are rising. The only way to know for sure is to give a simple and accurate blood test that can identify the disease. Elevance Health and its affiliated health plans, which insure one in eight births in the U.S., are working to create awareness to change the direction of this trend.

“This spike in disease is very concerning and largely preventable,” said Dr. Lynn Palmeri, a neonatologist, pediatrician, and medical director for Medicaid at Elevance Health. “Most cases of congenital syphilis and its lifelong consequences can be avoided with timely testing of pregnant women and treatment of mothers and babies with penicillin.”

According to the CDC, two in five cases (40 percent) of congenital syphilis were detected in babies born to mothers who did not receive any prenatal care. The CDC also says 90 percent of congenital syphilis cases can still be prevented, and social drivers of health are often influencers. For example, if people don’t have health insurance or transportation, they may not visit the doctor as often, so they may not have access to get tested. Others may not have access to care, such as people who live in rural communities.
 

How to Address the Rise in Syphilis

“The resurgence of maternal syphilis and subsequent congenital syphilis is tragic, especially because these diseases are highly preventable,” said Palmeri, who leads Elevance Health’s nationwide congenital syphilis effort to reduce the number of cases. “Our work provides education and resources to encourage use of prescribed healthcare services, both during pregnancy and after delivery.”

To ensure that care providers and patients are aware of and understand how to prevent congenital syphilis, Elevance Health-affiliated plans reach out in several ways. Provider communication newsletters and our award-winning OB practice consultant team reinforce medical protocols with clinical teams.  When claims data from lab work identifies women at high risk for syphilis, a health plan case manager reaches out to the member. Case managers then support mothers and babies with comprehensive care via frequent direct communications and reference materials.

“We want to make sure that every expectant mother is tested early and treated accordingly, and that means following standard of care and best practices,” Palmeri said.  These care guidelines for women and their children include those published by the Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Pediatrics (AAP).

“Because we cover so many of the nation’s births, we see how the national trends play out in our membership,” said Dr. Cynthia Brown, an obstetrician-gynecologist, medical director and clinical leader of women’s and children’s health at Elevance Health.

Brown said clinical managers can identify barriers to health when reaching out to members and help them navigate those obstacles to ensure they get appropriate care.

Every healthcare encounter during pregnancy is a chance to inform women so they can get the necessary tests and care, Brown said.

“Obstetricians see this resurgence first hand, and treating early means 98 percent of the time we can prevent illness in babies,” Brown said. “We’re following and promoting evidence-based medicine, and we’re informing care providers so they understand how to test and treat their patients.”

“Optimizing syphilis testing and treatment of pregnant women improves their health and helps maintain the mother-baby relationship after delivery,” Palmeri said. “Healthier babies don’t have to be admitted for 10 days to the neonatal intensive care unit (NICU) with blood draws, intravenous antibiotics, and a prolonged separation from the parents.”