Congenital syphilis can have a major health impact on a baby, but how it affects the baby’s health depends on when syphilis was acquired in pregnancy and if — or when — the mother received treatment for the infection. Syphilis in pregnant women can cause miscarriage, stillbirth, or the baby’s death shortly after birth. Approximately 40% of babies born to women with untreated syphilis can be stillborn or die from the infection as a newborn. Babies born with congenital syphilis can have bone damage, severe anemia, enlarged liver and spleen, jaundice, nerve problems causing blindness or deafness, meningitis, or skin rashes.
Syphilis can be treated effectively with a penicillin regimen that is both appropriate for the stage of syphilis and initiated 30 days or more before delivery. Pregnant women diagnosed with syphilis should be treated immediately. Their sex partner(s) should also receive treatment to prevent the mother from becoming re-infected and to improve the health of her partner. Infants exposed to syphilis during pregnancy should be thoroughly evaluated at birth to assess for evidence of congenital syphilis and need for treatment. These infants should also be closely followed post-delivery, regardless of initial evaluation or treatment, because infants with CS may not have any initial symptoms at birth but later develop symptoms of CS if not treated appropriately. Infants with CS who are not treated appropriately within the first 3 months of life are more likely to have lifelong complications of CS such as deafness, blindness, and intellectual disability.2,3
Number of pregnant women diagnosed with syphilis (any stage), United States1
Number of congenital syphilis cases, United States4
Number of primary and secondary syphilis cases among women aged 15 to 44 years, United States4
- Centers for Disease Control and Prevention. 2020 Sexually transmitted diseases surveillance. 2020 STD Surveillance Congenital Syphilis Figures. Accessed June 28, 2022.
- Lago EG, Vaccari A, Fiori RM. Clinical features and follow-up of congenital syphilis. Sex Transm Dis. 2013;40(2):85–94
- Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports. 2021 Jul 23;70(4):1.
- Centers for Disease Control and Prevention. NCHHSTP AtlasPlus. Accessed June 2020.