Protecting Your Baby: What You Need to Know About Congenital Syphilis

Pregnancy is an exciting time full of joy and anticipation, as well as a lot of important health decisions. At Legacy Community Health, we want to make sure you have all the information you need for a healthy pregnancy and baby. In this blog, we break down what congenital syphilis means for you and your baby and why it’s so preventable.

What is Congenital Syphilis?

Congenital syphilis happens when syphilis, an STI, passes from a pregnant person to their baby during pregnancy or delivery. We know that sounds scary, but there is good news: syphilis is both preventable and treatable. When you get tested and treated during pregnancy, you can protect your baby from this infection.

Why This Matters in Houston

We need to talk about what’s happening in our community. Houston has seen a 128% increase in congenital syphilis cases since 2019. Across Texas, there were 922 cases of congenital syphilis in 2022, which means approximately 1 in every 435 Texas babies was affected. That’s a 148% increase from 2018 to 2022.

This isn’t about pointing fingers or placing blame. It’s about making sure you have the information and care you need.

Understanding Who Is Most Affected

According to Dr. Wendi Monthy, Legacy’s Clinical OB/GYN Medical Director, research shows that certain social factors can create barriers to care and increase the risk of congenital syphilis.

“Substance use and homelessness can create an even greater barrier to care and increase the risk of congenital syphilis,” she explains. Other challenges, like a history of incarceration or lack of reliable transportation, can also make it harder to access care.

Some communities, including Black and Latina women, are disproportionately affected by syphilis.

Breaking Down Barriers to Testing

“The biggest barrier that prevents pregnant patients from getting tested or treated for syphilis is a lack of prenatal care or late prenatal care,” says Dr. Monthy. She says that 38% of the babies with congenital syphilis reported to the CDC in 2022 were born to parents who received no prenatal care.

This is why Legacy is committed to removing barriers and making prenatal care accessible to everyone.

Dr. Monthy also addresses a common misconception: “A woman may not think that she is at risk if she has no symptoms, is in a stable relationship, or is not currently sexually active. However, syphilis does not always cause any noticeable signs or symptoms. Also, a woman’s current or previous sexual partner can carry and transmit the disease without her realizing.”

What Happens if Syphilis Goes Untreated During Pregnancy

Untreated syphilis during pregnancy can have really serious consequences. According to the Centers for Disease Control and Prevention (CDC), up to 40% of babies born to mothers with untreated syphilis may be stillborn or die as newborns.

When syphilis isn’t treated during pregnancy, babies can face serious health problems like:

• Being born too early (premature birth)
• Low birth weight
• Physical disabilities
• Developmental delays
• Vision or hearing loss
• Seizures
• Jaundice and liver problems
• Bone abnormalities
• In the most severe cases, infant death

Worldwide, the numbers are alarming. In 2022, the World Health Organization (WHO) estimates that congenital syphilis led to 150,000 stillbirths, 70,000 newborn deaths, and 115,000 babies born with the infection.

These outcomes are heartbreaking. But remember: they’re preventable with the right care.

Prevention is Simple and Really Effective

Treatment during pregnancy is 98% effective at curing syphilis and protecting your baby. That’s an incredible success rate!

Texas Law is On Your Side

Here in Texas, you’re actually protected by law. Texas Health and Safety Code §81.090 requires health care providers to test pregnant women for syphilis three times throughout pregnancy:

1. During your first prenatal visit
2. During your third trimester (between 28-32 weeks)
3. At the time of delivery

This means your health care provider should automatically include these tests as part of your prenatal care.

How the Treatment Works

If you test positive, don’t panic. Benzathine penicillin G is the only CDC-approved treatment to prevent syphilis from passing to your baby during pregnancy, and it works really well. When treatment starts at least 30 days before delivery, it can prevent congenital syphilis.

Is Treatment Safe During Pregnancy?

Dr. Monthy offers reassurance to patients who may be nervous about taking antibiotics during pregnancy: “Penicillin has proven to be very safe and highly effective in pregnancy for decades. Penicillin does not harm the baby, but it can protect the baby from serious complications like stillbirth, developmental delays, and organ damage.”

Even if you’re allergic to penicillin, there are options. Health care providers can help with a process called desensitization so you can still receive this life-saving treatment.

Your Partner Needs to Get Treated Too

This is really important: if you test positive for syphilis, your sexual partner(s) need to get tested and treated as well. Without treatment, partners can pass the infection back to you, which means you’d have to start treatment all over again. Both of you should avoid sexual contact for 7 days after finishing treatment to give the antibiotics time to work.

What Happens If a Baby Is Born to Someone Who Had Syphilis

If you had syphilis during pregnancy, Dr. Monthy explains that your baby’s care team will take a careful, thorough approach after delivery. First, they’ll review your medical history, including what stage of syphilis you had and whether you completed treatment. Then they’ll give your baby a physical exam, checking for any signs of infection like a rash, jaundice, or an enlarged liver.

Your baby will also have blood tests to check for syphilis. If the doctors suspect congenital syphilis, your baby will receive IV penicillin and will need regular follow-up visits and blood tests with pediatric specialists. It might sound like a lot, but this careful monitoring is all about making sure your baby gets exactly the care they need.

What to Look For (But Symptoms Don’t Always Show Up)

When symptoms do show up, they might include:

• A rash on the palms of your hands or soles of your feet
• Sores in the genital area, rectum, or mouth
• Fever
• Swollen lymph glands
• Hair loss

Syphilis is sometimes called “the great imitator” because its symptoms can look like a lot of other illnesses. That’s why we can’t stress enough how important regular testing is during pregnancy, even if you feel perfectly fine.

What About Future Pregnancies?

If you’ve been treated for syphilis during a previous pregnancy, you may wonder if you’re protected for future pregnancies. Dr. Monthy has important information: “Even if a woman was treated for syphilis during a previous pregnancy, that does not guarantee protection in a subsequent pregnancy. Penicillin treatment does not provide lifelong protection.”

A woman can become infected again if re-exposed to syphilis, which means practicing prevention (avoiding unprotected sex with untreated partners) is critical. Syphilis testing should be repeated with every pregnancy.

“In future pregnancies, it is important to seek prenatal care early and report any history of syphilis to your clinician, as your antibody to syphilis will likely remain positive for life,” said Dr. Monthy. “This will help your clinicians direct your care accordingly.”

How Legacy Community Health Can Help

Legacy is concerned about the rise in congenital syphilis in our communities, and we’re dedicated to fighting the spread of this preventable infection.

Here’s what we offer to support you through a healthy pregnancy:

• Free walk-in HIV testing
• Affordable full-panel STI testing
• Free pregnancy testing
• Complete OB/GYN and prenatal care
• Same-day treatment when you need it
• Comprehensive pregnancy support services

Our health care team knows how to screen for syphilis and other STIs during pregnancy, and we can provide treatment right away if needed. Our whole goal is to make sure everyone in our community can get the care they need, no matter their insurance situation or ability to pay.

What You Can Do Right Now

If you’re pregnant or thinking about getting pregnant, here’s your action plan:

• Get prenatal care early. Starting prenatal care early is one of the most important things you can do to prevent congenital syphilis
• Make sure you get tested. You should receive all three syphilis tests during your pregnancy
• If you test positive, get treated right away. The treatment is safe during pregnancy and really effective
• Make sure your partner gets tested and treated too. This keeps you from getting reinfected
• Go to all your follow-up appointments. This helps make sure the treatment worked

Taking care of your sexual health is just part of taking care of your overall health and your baby’s health. We’re here to help you, not judge you.

Ready to Get Started?

We work with sliding scale fees and accept all types of insurance. Your health matters. Your baby’s health matters. Let’s work together to make sure you have the healthiest pregnancy possible. Make an appointment online or give us a call at (832) 546-5000.