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Syphilis and Pregnancy

What is congenital syphilis?
Congenital syphilis is syphilis, a Sexually Transmitted Disease (STD), that occurs when a pregnant individual with syphilis passes the infection on to the baby during pregnancy.

How common is congenital syphilis?
Congenital syphilis cases have more than tripled in recent years, with more than 2,000 cases reported in 2020 alone. This is the highest number reported in one year since 1994.

Public health professionals across the country are very concerned about the growing number of congenital syphilis cases in the United States. It is important to make sure you get tested for syphilis during your pregnancy.

How can I prevent myself from getting syphilis?
If you are sexually active, the following things can lower your chances of getting syphilis:

  • Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis.
  • Limiting partners.
  • Using latex condoms, the right way, every time you have sex. Although condoms can prevent transmission of syphilis by preventing contact with a sore, you should know that sometimes syphilis sores occur in areas not covered by a condom, and contact with these sores can still transmit syphilis.

Is there treatment for syphilis?
Yes. Syphilis can be treated and cured with antibiotics.

If you test positive for syphilis during pregnancy, be sure to get treatment right away. Do not wait for your next prenatal visit.

It is also important that your sex partner(s) receive treatment.

Having syphilis once does not protect you from getting it again. Even after you've been successfully treated, you can still be reinfected. For this reason, you must continue to take actions that will reduce your risk of getting a new infection.

Remember that it's possible to get syphilis and not know it, because sometimes the infection causes no symptoms, only very mild symptoms, or symptoms that mimic other illnesses.

If you are diagnosed with and treated for syphilis, your doctor should do follow-up testing for at least one year to make sure that your treatment is working.

I'm pregnant. Do I need to get tested for syphilis?
Yes. All pregnant women should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy).

In addition to that first visit, you can anticipate being tested during the following times, following  Pennsylvania guidelines:

  • At the third trimester of pregnancy
  • At the delivery of a child, or
  • At the delivery of a stillborn child

Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild, or be similar to signs of other infections.

How can I reduce the risk of my baby getting congenital syphilis or having health problems associated with congenital syphilis?
Your baby will not get congenital syphilis if you do not have syphilis.

There are three important things you can do to protect your baby from getting congenital syphilis and the health problems associated with the infection:

  • Plan your pregnancy with a visit to your doctor and get tested for all STDs
  • Get a syphilis test at your first prenatal visit
  • Reduce your risk of getting syphilis before and during your pregnancy

Prenatal care is essential to the overall health and wellness of you and your unborn child. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby.

Talk with your doctor about your risk for syphilis. Have an open and honest conversation about your sexual history and STD testing. Your doctor can give you the best advice on any testing and treatment that you may need.

Discuss any new or unusual physical symptoms you may be experiencing, as well as any drugs/medicines you are using, and whether you have new or multiple sex partners. This information will allow your doctor to make the appropriate testing recommendations. Even if you have been tested for syphilis in the past, you should be tested again when you become pregnant.

How can congenital syphilis affect my baby?
Congenital syphilis can have major health impacts on your baby. How it affects your baby's health depends on how long you had syphilis and if — or when — you received treatment for the infection.

Untreated syphilis can result in pregnancy complications including:

  • Miscarriage (losing the baby during pregnancy)
  • Stillbirth (a baby born dead)
  • Prematurity (a baby born early)
  • Low birth weight
  • Death shortly after birth

 Congenital syphilis can cause the following in a newborn:  

  • Deformed bones
  • Severe anemia (low blood count)
  • Enlarged liver and spleen
  • Jaundice (yellowing of the skin or eyes)
  • Brain and nerve problems, causing blindness or deafness
  • Meningitis
  • Skin rashes

How will my doctor know if my baby has congenital syphilis?
Your doctor must consider several factors to determine if your baby has congenital syphilis. These factors will include the results of your syphilis blood test and, if you were diagnosed with syphilis, whether you received treatment for syphilis during your pregnancy. Your doctor may also want to test your baby's blood, perform a physical exam of your baby, or do other tests, such as a spinal tap or an x-ray, to determine if your baby has congenital syphilis.

CDC has specific recommendations for your healthcare provider on how to evaluate babies born to women who have positive syphilis tests during pregnancy.

Do all babies born with congenital syphilis have signs or symptoms?
No. It is possible that a baby with congenital syphilis won't have any symptoms at birth. Without treatment, a baby may develop serious problems. Usually, these health problems develop in the first few weeks after birth, but they can also happen years later.

Babies who do not get treatment for congenital syphilis and develop symptoms later can die from the infection. They may also be developmentally delayed, have seizures, other health problems. The only way to know for sure if you have syphilis is to get tested.

My baby was born withcongenital syphilis. Is there a way to treat the infection?
Yes. There is treatment for congenital syphilis. Babies who have congenital syphilis need to be treated right away — or they can develop serious health problems. Depending on the results of your baby's medical evaluation, he/she may need antibiotics in a hospital for 10 days. In some cases, only one injection of antibiotic is needed.

It's also important that babies treated for congenital syphilis get follow-up care to make sure that the treatment worked.