By: Yarlini Vipulanandan, MD & Margaret Ikeda, MD, MS, FAAP
Syphilis is a
sexually transmitted infection that can spread to the fetus during pregnancy. The infection is called congenital syphilis when a fetus or newborn gets infected while inside the womb.
Pregnant people can become infected with syphilis before or during pregnancy. They may not know they have the infection as their symptoms may be mild and go unnoticed. During pregnancy, the syphilis infection can lead to
miscarriage, stillborn babies or babies with congenital syphilis. Pregnant individuals can pass syphilis to their unborn child at any stage of pregnancy.
Unfortunately, the number of babies in the United States born with congenital syphilis has
increased 10-fold in the last 10 years. The good news is that congenital syphilis is entirely preventable with the right testing and treatment during pregnancy. Learn more below.
How does congenital syphilis affect babies & children?
When born, babies with congenital syphilis may not show any signs of disease. Without treatment, babies and children with syphilis can have the following:
How does someone get syphilis?
Syphilis is an infection that spreads through sex. If a person is infected either before or during pregnancy—and is untreated or only partially treated—the infection can spread to the unborn baby.
Symptoms & stages of syphilis infection
Primary syphilis, the first stage, can appear as a painless sore on the genitals a few weeks after exposure. The sore may go unnoticed, particularly in women. Unless it is treated, the infection can spread throughout the body as
secondary syphilis. Signs of secondary syphilis may include a skin rash, swollen glands, fever, headache, joint aches or fatigue. It can last for months or even come back later if not treated.
How can I protect my baby from congenital syphilis?
You can
protect your baby by having a blood test for syphilis. The test can be positive if you have syphilis for the first time or even if you had syphilis in the past.
If you are diagnosed with syphilis, it is important to receive treatment right away. This should be followed by repeat blood tests to make sure the treatment worked. Since you can be infected at any time during pregnancy, your doctor may do the test more than once.
How is congenital syphilis diagnosed?
Two tests are done to detect syphilis:
Other testing on babies may be done to diagnose syphilis. This includes X-rays to view pictures of their bones, and a spinal tap to look at the fluid around the brain and spinal cord.
Is there a treatment for congenital syphilis?
Yes, there is treatment for congenital syphilis infection. Babies are treated with antibiotics as soon as possible after the infection is detected. This often occurs in the hospital.
After the first treatment, babies will have repeated blood tests over several months to make sure the infection is gone. Occasionally babies will need to be treated again. The baby's pediatrician will monitor and test the infant after the hospital discharges the baby.
Remember
Syphilis is a very serious infection during pregnancy that can result in the death of the unborn baby, or a baby born with congenital syphilis. Congenital syphilis is increasing in the United States as more adult cases of syphilis go untreated.
The best thing you can do to protect your baby is to have syphilis blood testing as soon as you discover you are pregnant and throughout pregnancy. If you are diagnosed with the infection, get treatment as soon as possible.
More information
About Dr. Vipulanandan
 Yarlini Vipulanandan, MD is a Pediatric Infectious Disease Fellow at the University of Alabama in Birmingham (UAB) and plans to pursue research regarding congenital infections. She completed her pediatric residency training at UT Southwestern Medical Center in Dallas, Texas. Dr. Vipulanandan is a post-residency training member of
American Academy of Pediatrics (AAP).
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About Dr. Ikeda
 Margaret Ikeda, MD, MS, FAAP, is a board-certified pediatrician working in primary care at the Yale University School of Medicine. She has been a member of the
American Academy of Pediatrics Section on Infectious Diseases for many years. Her interests include travel medicine, adoption, and sports medicine. She supports members of the Armed Forces.
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This article was supported by the cooperative agreement Number NU01DD000032, between the American Academy of Pediatrics and the Centers for Disease Control and Prevention.