After declining every year since 1990, in 2001, the incidence of syphilis began to increase, with the increase occurring most notably in men who have sex with men, minorities (African Americans and Hispanics), and in the southern states. Syphilis is most commonly reported in the 15- to 30-year-old age group. It occurs more frequently in men, but the incidence in women is steadily rising. Incidence is highest among urban populations. Prenatal transmission from an infected mother to her fetus is possible and occurs in at least 50% to 80% of exposed neonates. In the past, one-third of fetal demises were caused by maternal syphilis, but this number has decreased significantly with fewer incidences in pregnant women today.