Syphilis Testing and Pregnancy

Health care providers are required by Illinois law (410 ILCS 320/1) to screen all pregnant people for syphilis infection during the first prenatal visit and again during the third trimester. In the event any blood tests show a positive or inconclusive result, an additional test or tests must be performed. Infants should not be discharged from the hospital unless the syphilis serologic status of the birth parent has been determined at least one time during pregnancy and preferably again in the third trimester.

Risk factors include:

  • Multiple sex partners in the previous six months
  • Evaluation or treatment for STIs
  • Not previously tested or having a positive test in the first trimester
  • Behaviors that constitute an increased risk for an STI
  • Living in an area with high numbers of syphilis cases
  • Any person who delivers a stillborn infant after 20 weeks gestation should be tested for syphilis regardless of risk

Comprehensive recommendations for syphilis testing can be found in CDC Laboratory Recommendations for Syphilis Testing, United States 2024.