Neonatal syphilis: clinical and laboratory assessments and postnatal treatments for infants born to infected mothers.

Abstract

Purpose: This study aims to assess congenital syphilis incidence, main clinical presentations and the relation to maternal treatment during pregnancy, with the goal of raising awareness of this emerging public health issue and offering local epidemiological data.

Methods: Infants born to mothers diagnosed with syphilis at Etlik City Hospital between June 1, 2023 and June 1, 2024 were included to the study. Patient records were reviewed retrospectively.

Results: During the study period, 12,892 live births were recorded, with congenital syphilis detected in 0.12% of cases, corresponding to a rate of 116 cases per 100,000 live births. Fifteen neonates born to mothers with syphilis were evaluated. Penicillin treatment was administered to 93.3% of the neonates, including 73.3% classified as highly probable or probable cases. Bone abnormalities such as periostitis and osteitis were detected in two patients. Only 46.7% of mothers received adequate prenatal treatment, and 40% lacked prenatal care altogether. Co-infections with hepatitis C virus, human papillomavirus, and herpes simplex virus type 2 were noted in 26% of mothers, though none had HIV. Substance addiction was reported in 26.7% of mothers.

Conclusion: This study highlights a significant burden of congenital syphilis, with many cases stemming from untreated or inadequately managed maternal infections. Some neonates were infected despite maternal treatment, underscoring gaps in prevention. The limited data from our center, despite high case rates, likely underestimates the regional burden and risks missed diagnoses. These findings emphasize the urgent need for enhanced prenatal screening, timely treatment, and comprehensive care to mitigate congenital syphilis rates.