Congenital Syphilis Fact Sheet

Universal screening of all pregnant women for syphilis is important and is the standard of care in most jurisdictions across Canada. All pregnant women should receive pre-natal care including evaluation for risk factors and screening for sexually transmitted infections (STI) prior to and during pregnancy.

Background

Infectious syphilis rates in Canada have been on the rise since 1997. These increases in rates are driven largely by outbreaks of syphilis across Canada, both in men who have sex with men as well as in the heterosexual population. Recently, because of the outbreaks of infectious syphilis in the heterosexual population, Canada is seeing a concerning rise in the number of congenital syphilis cases. In the decade prior to 2005, 2 congenital syphilis cases or less were reported per year. Preliminary reports indicate that there were 8 cases each in 2005 and 2006.

What is congenital syphilis?

Congenital syphilis is a type of syphilis infection seen in babies born to mothers who are infected with the bacteria during pregnancy. 

How is syphilis transmitted?

Syphilis can be transmitted through unprotected oral, vaginal, and anal sex. Syphilis can be transmitted from an infected mother to her infant during pregnancy (congenital syphilis), or less commonly, through contact with syphilis lesions at the time of birth.

What are the symptoms of syphilis in pregnancy?

A pregnant women newly infected with syphilis will often have no symptoms, or may develop sores on the genital area or mouth (if engaging in oral sex). In the second stage of syphilis, a rash, fever and swollen glands may develop.

What will happen if you are infected with syphilis while pregnant?

If a pregnant woman is infected with syphilis she can transmit the infection to the infant during the pregnancy or less commonly during birth.  Pregnant women are usually tested for syphilis during the routine blood tests in early pregnancy. If a woman is diagnosed with syphilis while pregnant, she can be treated with medication that can reduce the chances of syphilis passing on to the infant. If the infected mother is over 20 weeks pregnant, an ultrasound may also be performed. Depending on how long the pregnant woman has been infected and even if she receives treatment, the baby may be born with congenital syphilis.

What are the symptoms of congenital syphilis?

Congenital syphilis can result in significant health problems to the infant including skin lesions, disseminated infection (infection throughout the body), enlarged liver and spleen, infection in the brain and even death. An infected baby may be born without signs or symptoms of the disease. The doctor will probably refer you to a specialist to make sure that the baby does not develop complications.  It is very important to make sure that you follow your doctor's recommendations for follow-up for the baby.

How can you protect yourself and your baby?

The risk of infection can be reduced by practicing mutual monogamy, reducing the number of sexual partners and using condoms or other barrier methods for oral, vaginal and anal sex.  If you are pregnant and think you may be at risk of getting or being infected with syphilis, you should be tested early in your pregnancy and follow your doctor's recommendations for repeat testing during your pregnancy depending on how common syphilis is in your region your personal risk and your partner's risk (to find out about infectious syphilis rates in your region please contact your local health department). If you do get infected, early diagnosis and treatment may help to prevent infection in the baby.

How do you get tested for syphilis?

Syphilis testing is done through a blood sample.  You will need to see your doctor so that the test can be ordered.

How is it treated?

Syphilis is usually treated with penicillin injections. If you have not been tested for HIV, your doctor will perform an HIV blood test because longer treatment may be required in people who also have HIV.  HIV is also more likely to be passed on if you are exposed to it at the same time as syphilis.

Women who are treated for syphilis in the second half of their pregnancy are at increased risk for premature labour and/or fetal distress related to the treatment.  If after receiving your treatment, you notice any change in fetal movement or if you feel contractions, seek immediate medical attention.

It is very important that your partner(s) be notified, tested and treated to prevent you from getting re-infected.

Your doctor will order repeat syphilis blood tests during your pregnancy to make sure that the treatment worked.

How is the baby tested for congenital syphilis?

Testing for the baby is done through a blood test at birth. If there is suspicion that the baby might have congenital syphilis close clinical monitoring will be required.  Your physician will work with a specialist to ensure the baby gets proper testing and follow-up.  Minimally your baby should be thoroughly examined at birth, and once a month for at least 3 months to monitor for signs and symptoms of complications so that steps can be taken to protect the health of your child.

For additional information contact your local public health department.