A resurgence of maternal syphilis is exposing stark racial health disparities, with Black women bearing a disproportionate burden of an epidemic that public health officials once thought could be eliminated.
Syphilis rates among pregnant women in Mississippi increased nearly 10-fold between 2018 and 2023, according to research cited by Dr. Robert L. Cook of the University of Florida. Nationally, the US experienced a nearly 700% increase in congenital syphilis diagnoses between 2015 and 2024, with nearly 4000 cases reported in 2024.
Women with maternal syphilis tended to be younger than 25 years, unmarried, Black, and living in the Southeastern US. These demographic patterns reflect broader risk factors associated with sexually transmitted infections in US women. Cook noted that 90.1% of affected women were unmarried.
The crisis is compounded by syndemic factors including substance abuse, incarceration, and lack of health insurance, each impacting access to prenatal care. More than one-third of women with maternal syphilis did not have a perinatal visit in the first trimester, representing delayed access to crucial care.
While recent data suggest syphilis rates may be decreasing among men, women have been left behind. Rates of congenital syphilis and women with later-stage syphilis diagnoses continued to increase in 2024 even as overall rates declined.
Cook emphasized the need to strengthen strategies that reduce stigma related to being pregnant and unmarried, substance use, incarceration, and lack of private health insurance. The current rates of maternal and congenital syphilis are among the highest ever recorded in the US.
See: “The Resurgence of Maternal Syphilis—A Public Health Wake-Up Call” (December 30, 2025)