Congenital syphilis: clinical repercussions and neonatal prognosis.

Abstract

Congenital syphilis (CS) is a serious infection and remains a major public health problem in Brazil, resulting from vertical transmission of Treponema pallidum. Although largely preventable through simple diagnosis and low-cost treatment, the high incidence and morbidity/mortality rates highlight shortcomings in maternal and child care. This integrative review analyzed the clinical manifestations, neonatal outcomes, and prognostic factors of CS based on studies published between 2014 and 2024 in the SciELO, LILACS, PubMed, and BVS databases. The results reveal a worrying scenario, with an incidence of 9.9 cases per 1,000 live births in 2023—well above the Pan American Health Organization target of 0.5/1,000. A broad clinical spectrum was observed, with a predominance of asymptomatic newborns, and an association between inadequate maternal treatment and high serological titers and worse outcomes, such as prematurity and neonatal death. The conclusion is that the persistence of CS reflects structural deficiencies in prenatal care and primary care. Strengthening the care network, with timely diagnosis and appropriate treatment of pregnant women and their sexual partners, is essential to reduce vertical transmission and achieve effective disease control in Brazil.