. Conclusions
Syphilis infection during pregnancy still represents a worldwide public health problem. The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recommend prenatal syphilis screening at the first prenatal visit and again at 32–36 weeks, if the woman is at risk for syphilis [47]. CDC recommends that all women should be screened serologically for syphilis at the first prenatal visit and, for patients at high risk, during the third trimester and at delivery [7]. Moreover, any woman who delivers a stillborn infant after 20 weeks’ gestation should be tested for syphilis [36]. The Italian Guidelines of Istituto Superiore di Santità for Physiological Pregnancy (2011) stated that serological screening for syphilis should be offered to all pregnant women during the first and the third trimester of pregnancy [48]. Preconception serological tests for syphilis could represent the key to reduce the incidence of CS. Moreover, preconception counseling could play an important role, evaluating the woman and her partner for exposure to sexually transmitted diseases, identifying high-risk behaviors, and providing health promotion messages and education