The decision to implement screening for infections during pregnancy depends upon epidemiological, economic, therapeutic and test performance criteria. It therefore varies with public health priorities from country to country. When screening is implemented, first trimester has become the best time slot to build individual care pathways also in this field. This is most relevant for evaluating the risk of embryonic consequences, plan diagnostic testing, initiate primary or secondary prevention and increase the accuracy of ultrasound follow-up. This is a critical appraisal of epidemiological data and current international screening recommendations for infections in pregnancy.