Abstract
The global resurgence of syphilis is affecting Aotearoa New Zealand (NZ). It is having inequitable impacts amongst Māori and Pacific whānau and for women in pregnancy and their pēpē. The consequences of syphilis in pregnancy include fetal death, prematurity, and critically ill newborns. Prior to 2017, reports of congenital syphilis were rare however in the last 5 years NZ has had over 25 cases. Some hapū māmā continue to miss out on essential antenatal healthcare, including syphilis screening and treatment. Although syphilis screening is performed early in pregnancy, this can miss early infections or syphilis acquired later in pregnancy. Repeat testing for syphilis can be done in the third trimester guided by a risk assessment yet this can be stigmatizing, inequitable and may continue to miss cases. In the northern region of NZ, a new initiative supports all pregnant women to be offered repeat testing for syphilis later in pregnancy as part of the effort to stem the rise in congenital cases.