• Congenital Syphilis Fact Sheet (PDF)

What is congenital syphilis? 

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Congenital syphilis is the disease that happens when a pregnant person passes syphilis to their baby during pregnancy. Congenital syphilis cases have more than tripled in recent years making it more important for you to get tested for syphilis during your pregnancy. 

People that are sexually active can contract a syphilis infection. The bacteria that cause this infection can spread through the placenta from a pregnant person to their developing baby. Syphilis infection would be present at birth in the baby. 

Signs of symptoms in those aged birth – 2 years include: 

• Bone abnormalities 
• Enlarged liver and spleen 
• Jaundice (yellowing of the skin or eyes) 
• Low red blood cell count (anemia) and low platelet count (thrombocytopenia) 
• Soft, wart-like lesions (condyloma lata) 
• Peeling skin on hands or feet 
• Rash on neck, arms, or mouth area 
• Runny nose, typically persistent starting within one week of birth, white drainage may contain blood 
• Meningitis – Infection of the brain 

About 6 in 10 newborns with symptoms of congenital syphilis have neurosyphilis which may include stroke, eye abnormalities and seizures. 

Signs and symptoms in those over age 2 include: 

• Abnormal bone growth 
• Eye abnormalities 
• Hearing loss 
• Teeth that are notched or have gaps in between them 

What are the complications of congenital syphilis? 

How congenital syphilis affects a baby’s health depends on how long the pregnant parent had syphilis and if, or when, they received treatment for the infection. 

Congenital syphilis can cause: 

• Miscarriage 
• Stillbirth 
• Prematurity 
• Low birth weight 
• Death shortly after birth 

Babies with congenital syphilis need to be treated right away or they can develop serious health problems. If your baby has congenital syphilis, they will most likely be treated in the hospital with antibiotics. Antibiotics can treat the syphilis infection, but they cannot reverse any of the damage to your baby’s health that occurred before they were given this medicine. Ideal treatment occurs during pregnancy, at least 30 days before birth. 

Contact your healthcare provider if you’re pregnant and believe you may have syphilis. It’s important to get tested right away so you can start treatment if you test positive. Follow-up testing is necessary to confirm your treatment was successful. Your sex partner(s) need to get tested and treated too. 

If your child is diagnosed with congenital syphilis, they will be treated by the hospital after birth or their pediatrician. After their first treatment, your child’s pediatrician will conduct repeat blood tests over several months to confirm the infection is gone. Additional treatments may be needed. Take your child to all appointments and follow their care team’s instructions. 

Reduce your risk of contracting syphilis during or before pregnancy: 

• Practice safe sex with condoms and/or dental dams 
• Get tested and treated for STIs and ensure your sexual partner(s) are tested and treated as well. 
• Attend all prenatal visits 

Get a syphilis test the first time you see a healthcare provider during pregnancy. Some pregnant individuals should get tested again at the beginning of the third trimester and again when baby is born.