Congenital Syphilis

Key Points

People who are sexually active can get syphilis, a curable sexually transmitted infection (STI).
Syphilis can pass to babies during pregnancy.
Protect your baby by getting tested and treated for syphilis during your pregnancy.

What it is

Congenital syphilis (CS) occurs when syphilis passes to babies during pregnancy. Syphilis is an STI that can cause serious health problems without treatment.

CS cases have more than tripled in recent years, with nearly 4,000 cases reported in 2024 alone. This is the highest number reported in one year since 1994.

Signs and symptoms

How can CS affect my baby?

CS can have major health impacts on your baby. How CS affects your baby's health depends on how long you had syphilis and if — or when — you got treatment for the infection.

CS can cause

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

Babies born to people with untreated syphilis may be stillborn or die from the infection as a newborn.

Babies born with CS can have

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

Do all babies born with CS have signs or symptoms?

No. It is possible that a baby with CS won't have any symptoms at birth. However, if the baby does not receive treatment right away, the 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 CS and develop symptoms later on can die from the infection. They may also be developmentally delayed or have seizures.

How it spreads

People who are sexually active can get syphilis, a common, treatable STI. Syphilis can pass to babies during pregnancy.

Prevention

I'm pregnant. How can I keep my baby from getting syphilis?

Your baby will not get CS if you do not have syphilis. There are two important things you can do to protect your baby from getting CS and the health problems associated with the infection:

Get a syphilis test the first time you see a healthcare provider during pregnancy.
Reduce your risk of getting syphilis before and during your pregnancy.

If you are sexually active, have an open and honest conversation with your healthcare provider. Ask them if you should get tested for syphilis and other STIs.

Get a syphilis test the first time you see a healthcare provider during pregnancy.

Getting tested and treated for syphilis can prevent serious health complications for you and your baby.

At your first healthcare visit, ask your healthcare provider about getting tested for syphilis. You can discuss

Any new or unusual physical symptoms you may be experiencing
Any drugs or medicines you are using
Whether you have new or multiple sex partners
Your risk for syphilis, such as the number of syphilis cases in your area

This information will allow your healthcare provider to make the appropriate testing recommendations. Some people should get tested again at the beginning of the third trimester and again when the baby is born.

Even if you have been tested for syphilis in the past, you should get tested again when you become pregnant.

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

If you test positive for syphilis, you will need treatment right away. It is also important that your sex partner(s) get treated. Syphilis is curable with the right antibiotics from your healthcare provider. Follow-up testing by your healthcare provider is necessary to make sure your treatment was successful.

Having syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again. For this reason, you must continue to take actions that will reduce your risk of getting a new infection.

Reduce your risk of getting syphilis before and during your pregnancy.

Preventing syphilis among those who are sexually active is the best way to prevent CS.

The only way to completely avoid STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to 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.
Using condoms the right way every time you have sex.

Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Testing and diagnosis

How will my healthcare provider know if my baby has CS?

Your healthcare provider must consider several factors to determine if your baby has CS. These factors will include the results of your syphilis blood test and whether you received treatment for syphilis during your pregnancy if you were diagnosed with syphilis. Your healthcare provider 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 CS.

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

Treatment and recovery

My baby was born with CS. Is there a way to treat the infection?

Yes. There is treatment for CS. Babies who have CS need to be treated right away — or they can develop serious health problems. Depending on the results of your baby's medical evaluation, they 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 CS get follow-up care to make sure that the treatment worked.

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