Pregnancy screenings by week
The USPSTF recommends a short list of tests and preventive steps in pregnancy, most of them at the first prenatal visit. Below they are in order of when they happen, each with its grade and date. Your prenatal care team decides what you need and when.
The timeline at a glance
| When | What | USPSTF grade, date |
|---|---|---|
| Before pregnancy | Folic acid, 0.4 to 0.8 mg every day | A, August 1, 2023 (USPSTF, 2023) |
| First prenatal visit | HIV test | A, June 11, 2019 (USPSTF, 2019) |
| First prenatal visit | Hepatitis B test (HBsAg) | A, July 23, 2019 (USPSTF, 2019) |
| First prenatal visit | Syphilis test | A, May 13, 2025 (USPSTF, 2025) |
| First prenatal visit | Rh(D) blood type and antibody test | A, February 15, 2004 (USPSTF, 2004) |
| First visit or 12 to 16 weeks, whichever is earlier | Urine culture for bacteria without symptoms | B, September 24, 2019 (USPSTF, 2019) |
| Every prenatal visit | Blood pressure, for preeclampsia and other high blood pressure disorders | B, September 19, 2023 (USPSTF, 2023) |
| After 12 weeks | Low-dose aspirin (81 mg a day), only if at high risk of preeclampsia | B, September 28, 2021 (USPSTF, 2021) |
| 24 weeks or later | Gestational diabetes screening | B, August 10, 2021 (USPSTF, 2021) |
| 24 to 28 weeks | Repeat Rh(D) antibody test, if Rh(D)-negative and not sensitized | B, February 15, 2004 (USPSTF, 2004) |
| During pregnancy and after birth | Counseling to prevent depression, if at increased risk | B, February 12, 2019 (USPSTF, 2019) |
This page is not part of the screening planner: the planner works by age and sex, and these depend on pregnancy and its week.
Before pregnancy: folic acid
Anyone planning to or who could become pregnant should take a daily supplement with 0.4 to 0.8 mg (400 to 800 mcg) of folic acid, starting at least 1 month before conception and continuing through the first 2 to 3 months of pregnancy. (USPSTF, 2023) It does not apply to people with a past pregnancy affected by a neural tube defect or other very high risk; they should ask their doctor. More: folic acid before pregnancy.
First prenatal visit
HIV
The USPSTF recommends HIV screening for all pregnant persons, including those who arrive in labor or at delivery with unknown HIV status (grade A, 2019). It notes that ACOG and the CDC advise a repeat test in the third trimester for women with risk factors or living in high-incidence areas, and that women screened in an earlier pregnancy should be rescreened. (USPSTF, 2019) The 2019 statement is being updated; no draft has been posted. More: HIV screening.
Hepatitis B
A blood test for hepatitis B surface antigen (HBsAg) at the first prenatal visit, in each pregnancy, even after vaccination or an earlier negative test (grade A, 2019). People with unknown status or ongoing risk are tested again when admitted for delivery. (USPSTF, 2019) More: hepatitis B testing.
Syphilis
The USPSTF recommends testing everyone who is pregnant, as early as possible, whether or not they have risk factors; if it was missed, at the first chance, even at delivery (grade A, May 2025). (USPSTF, 2025)
Where others differ: the USPSTF found too little evidence to judge testing more than once. ACOG recommends retesting everyone in the third trimester and at birth; the CDC, WPSI and AAP recommend retesting at 28 weeks and at delivery for women at high risk. Some states require repeat testing. (USPSTF, 2025) More: syphilis screening.
Rh(D) blood type
Rh(D) blood typing and an antibody test at the first pregnancy visit (grade A). If you are Rh(D)-negative and have not developed antibodies, the test is repeated at 24 to 28 weeks, unless the biological father is known to be Rh(D)-negative (grade B). (USPSTF, 2004) This statement dates from 2004 and is the current USPSTF recommendation.
Urine culture
A clean-catch urine culture at the first prenatal visit or at 12 to 16 weeks, whichever is earlier, to find bacteria in the urine before they cause symptoms (grade B, 2019). Outside pregnancy, the USPSTF recommends against this test for adults without symptoms (grade D). (USPSTF, 2019) How a culture differs from a routine urine test: urinalysis results.
Every visit: blood pressure
The USPSTF recommends a blood pressure check at each prenatal visit, throughout pregnancy, to find preeclampsia and other high blood pressure disorders (grade B, 2023). A high reading should be confirmed with repeat measurements, and anyone who screens positive needs follow-up care. (USPSTF, 2023) The numbers used, urine and blood checks and the warning signs: preeclampsia screening. Outside pregnancy: blood pressure checks by age.
After 12 weeks: aspirin if at high risk of preeclampsia
For people at high risk of preeclampsia, the USPSTF recommends low-dose aspirin, 81 mg once a day, after 12 weeks (grade B, 2021). High risk means one or more of: preeclampsia in a past pregnancy, twins or more, chronic high blood pressure, type 1 or 2 diabetes before pregnancy, kidney disease, or autoimmune disease such as lupus or antiphospholipid syndrome. A combination of several moderate risk factors may also count, such as a first birth, a BMI over 30 before pregnancy, a mother or sister who had preeclampsia, or being 35 or older. (USPSTF, 2021)
ACOG timing: ACOG and the Society for Maternal-Fetal Medicine advise starting between 12 and 28 weeks, ideally before 16 weeks, and continuing daily until delivery. (ACOG, 2021) Only start aspirin if your prenatal care team advises it. This is a different question from daily aspirin for the heart.
24 to 28 weeks: glucose test and Rh(D) recheck
The USPSTF recommends screening for gestational diabetes at 24 weeks or later in people without diabetes before pregnancy (grade B, 2021). It found the evidence insufficient to recommend for or against screening before 24 weeks (I statement). Common methods are a 1-hour 50 g glucose drink test followed by a longer test if the result is high, or a single 2-hour 75 g test after fasting. (USPSTF, 2021) The cut-offs for each test: gestational diabetes glucose test results.
Where ACOG differs: ACOG says people with risk factors have their blood sugar tested early in pregnancy, and everyone else between 24 and 28 weeks. (ACOG) Diabetes outside pregnancy: diabetes screening by age.
The repeat Rh(D) antibody test for Rh(D)-negative people also falls at 24 to 28 weeks (see first visit). (USPSTF, 2004)
During pregnancy and after birth: depression
The USPSTF recommends that clinicians provide or refer pregnant and postpartum people at increased risk of perinatal depression to counseling (grade B, 2019). It says no tool accurately predicts who is at risk; risk factors it lists include a history of depression, current symptoms that do not meet a diagnosis, low income, adolescent or single parenthood, recent intimate partner violence, high anxiety, or major negative life events. (USPSTF, 2019) A draft update posted April 22, 2025 keeps grade B; it is a draft, not final. (USPSTF draft, 2025) Depression screening for all adults, including during and after pregnancy: depression screening.
Also asked during pregnancy
- Whether you feel safe with your partner: intimate partner violence screening.
- Smoking and help to quit: quitting smoking.
Questions people ask
What tests are done at the first prenatal visit?
The USPSTF recommends tests for HIV, hepatitis B and syphilis, Rh(D) blood type and antibodies, and a urine culture for bacteria (at the first visit or at 12 to 16 weeks, whichever comes first). Blood pressure is checked at this and every later visit. Your prenatal care team may add others. (USPSTF, 2019) (USPSTF, 2019) (USPSTF, 2025) (USPSTF, 2004) (USPSTF, 2019) (USPSTF, 2023)
When is the glucose test in pregnancy?
The USPSTF recommends screening for gestational diabetes at 24 weeks or later (grade B, 2021). It found the evidence insufficient for screening earlier. ACOG says people with risk factors are tested early in pregnancy, and others between 24 and 28 weeks. (USPSTF, 2021) (ACOG)
Do I need these tests again if I was tested in a past pregnancy?
For hepatitis B, the USPSTF says to test in each pregnancy, even after vaccination or an earlier negative result. For syphilis, the USPSTF summarizes CDC, AAP and ACOG advice to test at the first visit even if tested before. For HIV, it notes that people screened in a previous pregnancy should be rescreened. (USPSTF, 2019) (USPSTF, 2025) (USPSTF, 2019)
Who should take low-dose aspirin in pregnancy?
The USPSTF recommends 81 mg a day after 12 weeks for people at high risk of preeclampsia (grade B, 2021). High risk includes a past pregnancy with preeclampsia, twins or more, chronic high blood pressure, diabetes before pregnancy, kidney disease, or autoimmune disease such as lupus. Only start aspirin if your prenatal care team advises it. (USPSTF, 2021)
Is depression checked during pregnancy?
The USPSTF recommends counseling for pregnant and postpartum people at increased risk of perinatal depression (grade B, 2019), such as those with past depression, current symptoms, recent partner violence, or low income. A 2025 draft (not final) keeps the same grade. (USPSTF, 2019) (USPSTF draft, 2025)
Does this replace my prenatal care plan?
No. This is a summary of national recommendations. Your prenatal care team decides which tests you need and when, based on your history and where you live.