Congenital syphilis occurs when a mother who has syphilis during pregnancy transmits the disease to her growing fetus. Congenital syphilis can cause neurological problems such as seizures and developmental delays as well as other problems with the kidneys, spleen, bones, facial features and joints. More worrisome still is the fact that untreated syphilis during pregnancy can lead to stillbirth or early infant death in up to 40 percent of affected infants.
Congenital syphilis can be somewhat difficult to diagnose in an infant, because the standard diagnosis is based on a blood test that looks for antibodies to the syphilis bacterium, and those antibodies can be transmitted from the mother to the child. Therefore, when congenital syphilis is suspected, doctors must use a somewhat complicated protocol to try to determine whether or not a child is actually infected, and it may require repeated testing and judgment calls. Treatment of infants with congenital syphilis is with various forms of penicillin; the specific regimen will depend on both maternal and infant test results and specific signs of disease.
Because the complications of congenital syphilis can be so severe, the CDC recommends that all women be screened for syphilis at their first prenatal visit and that women at high risk of congenital syphilis be screened again at 28 weeks. A woman's sexual partner(s) should also be tested and treated to avoid the possibility of reinfection.
Sources:
Centers for Disease Control. STD Surveillance, 2007 - Syphilis. Accessed 2/9/09.
Centers for Disease Control. Congenital Syphilis - STD Treatment Guidelines 2006. Accessed 2/9/09.
Centers for Disease Control. STD Facts - Syphilis. Accessed 2/9/09.
Centers for Disease Control. Guidelines for the Prevention and Control of Congenital Syphilis. MMWR 1988;37(suppl no. S-1). Accessed 2/9/09.
