Closing the gap in gestational syphilis: from screening to prevention of congenital transmission

Abstract

Gestational syphilis continues to be a public health problem despite effective and low-cost diagnosis and treatment. It is considered a re-emerging disease, caused by Treponema pallidum (T. pallidum), this infection can be transmitted to the fetus and give rise to congenital syphilis, responsible for abortions, neonatal death, preterm delivery and neurological sequelae. Worldwide, it is estimated that 7 out of every 1000 pregnant women have the infection, with more than 200 thousand neonatal deaths per year, in Colombia, and particularly in Norte de Santander, the rates have remained high between 2016 and 2021, which shows failures in access and follow-up of prenatal control. Most pregnant women are in the latent and asymptomatic phase, so the diagnosis depends on treponemal and non-treponemal serological tests (Stafford et al., 2024). The treatment of choice is benzathine penicillin G, applied according to the stage of the disease; This review article analyzes the current evidence on epidemiology, clinical manifestations, diagnosis, and management of gestational syphilis, in order to offer a practical tool for the comprehensive approach to the mother-child binomial and reduce vertical transmission.