Congenital Syphilis

What is congenital syphilis?  

Congenital syphilis is a disease that occurs when a mother with syphilis -- a sexually transmitted infection that can cause serious health problems if not treated -- passes the infection on to her baby during pregnancy through the placenta. The infection can also be passed to the baby during labor and delivery.

Syphilis can be treated and cured with antibiotics. If you test positive for syphilis during pregnancy, be sure to get treatment right away. 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.

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 or 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. A baby born with congenital syphilis can be treated.

According to Georgia's General Assembly Senate Bill 46, All pregnant women in Georgia should be tested for HIV and Syphilis at the first prenatal visit, 28-32 weeks gestation, and most importantly for hospital providers, at the time of delivery. This is mandated by Georgia law. 

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 similar to signs of other health problems. The only way to know if you have syphilis is to get tested.

If you are pregnant, and have syphilis, you can still reduce the risk of congenital syphilis in your baby. Getting tested and treated for syphilis can prevent serious health complications in both mother and baby.

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.

At your first prenatal visit, it is mandated by law that you receive testing for HIV and Syphilis. It is important that you have an open and honest conversation with your doctor at this time about your sexual history and about STD testing. 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.

If you test positive for syphilis, you will need to be treated 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 re-infected. For this reason, you must continue to take actions that will reduce your risk of getting a new infection.

Preventing syphilis in women and their sex partners is the best way to prevent congenital 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.
• 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.

Also, talk with your doctor about your risk for syphilis. Your doctor can give you the best advice on any testing and treatment that you may need.

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.

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

• Get a syphilis test at your first prenatal visit
• Receive syphilis testing at 28-32 weeks gestation and 
• Get a syphilis test at delivery.
• Reduce your risk of getting syphilis before and during your pregnancy.

The HIV and Syphilis Pregnancy Senate Bill 46 was passed and the law went into effect July 1, 2023. The law mandates that all pregnant women be tested for syphilis and HIV at the first prenatal visit, at 28-32 weeks gestation and at delivery.

Key points of the law: 

• Every physician and health care provider who provides prenatal care must test pregnant women for syphilis and HIV at the 1st prenatal care visit, at 28-32 weeks gestation and at time of delivery.
• Syphilis treatment (benzathine penicillin G only) initiated at least 30 days before birth has proven effective at decreasing the chances that a baby is born with congenital syphilis.
• Treatment for HIV should be initiated immediately. HIV antiretroviral therapy during pregnancy, at the time of delivery, and prophylaxis to the newborn dramatically reduce perinatal transmission of HIV. 
• Georgia law also requires all Georgia physicians, laboratories, and other healthcare providers to report patients with syphilis infections to the Georgia Department of Public Health (Georgia Code OCGA §31-12-2). Both laboratory-confirmed and clinical diagnoses are reportable within the specified time intervals.

Providers should make testing for syphilis and HIV at the first prenatal visit, at 28-32 weeks gestation and during delivery a part of their routine care for pregnant persons – because it is the law and for the health and well-being of every mother and child in Georgia.

For additional information about mandatory testing, please contact your local district health office or call the Georgia Department of Public Health at 1-866-PUB-HLTH (1-866-782-4584). You can schedule testing for syphilis and HIV by calling the Georgia AIDS and STD information line for assistance at: 1-800-551-2728.

Where can I get more information?

STD information and referrals to STD Clinics
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: [email protected]

American Sexual Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877