Congenital Syphilis

A mother and her child

Do you know that an infected mother can pass syphilis to her unborn child? Recent report shows that syphilis remains a leading cause of baby loss globally, resulting in over 200 000 stillbirths and newborn deaths every single year. This occurs in spite of the fact that congenital syphilis is easily preventable and treatable when transmitted during pregnancy. 

According to a report by the World Health Organization (WHO) published on February 27, 2019, "new estimates show that there were more than half a million (around 661 000) total cases of congenital syphilis in 2016, resulting in over 200, 000 stillbirths and neonatal deaths."

What is Syphilis?

Syphilis is a bacterial infection caused by a bacterium known Treponema pallidum, and it can often be recognized by the presence of an open sore, known as a chancre, on the genitals, mouth, anus, or rectum. This infection is one of the most common sexually transmitted infections globally, with approximately 6 million new cases each year.  If an infected pregnant woman does not receive early and effective treatment, she can then pass on the disease to her unborn infant. This is known as ‘congenital syphilis’, which often results in death. It can also cause low birth weight, prematurity, and other congenital deformities.

It is important to note that after malaria, congenital syphilis is the second leading cause of preventable stillbirths globally.

Prevention and Treatment

Congenital syphilis can be easily prevented and treated – as long as pregnant women receive testing and treatment early during antenatal care. Ideally before the second trimester, if a infected pregnant woman receives testing and adequate treatment with benzathine penicillin, the risk of adverse outcomes to the fetus is minimal.

New Estimates

Co-authored by WHO and HRP with partners, and published in the scientific journalPLOS ONE, the new estimates show that out of the 661,000 total cases of congenital syphilis, there were 355,000 adverse birth outcomes – which represents a significant proportion of newborn death and disease.

The estimates showed that the overall global burden of congenital syphilis decreased over the 2012 to 2016 research period, although non-significantly, from around 750,000 to 660,000 cases. The research also found some improvements in screening, treatment, and surveillance of maternal syphilis. Estimated adverse birth outcomes due to congenital syphilis decreased slightly from 397,000 to 355,000.

Action Needed

Despite the decrease between 2012 and 2016, the numbers of affected women and infants remains unacceptably high. It is crucial that all women are provided with early syphilis screening and treatment as part of high-quality antenatal care for a positive experience of pregnancy.

In addition, health systems and programmes need to ensure that all women diagnosed with syphilis, as well as their infants, are effectively treated – and that their sexual partners are reached for testing and treatment. Countries can also work to reduce syphilis prevalence across populations, by ensuring that testing, treatment and partner referral for the infection are put into action, beyond that of antenatal care.

Sources:

1. https://www.who.int/reproductivehealth/congenital-syphilis-estimates/en/

2. https://www.verywellhealth.com/syphilis-an-overview-3132670

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