Congenital Syphilis: What to Expect for Your Newborn

Congenital syphilis in newborns?

Hello Doctor, I had a syphilis infection during my pregnancy, so I brought my baby in for a blood test after birth.
The results showed RPR 1:4, and the hospital wants us to be admitted.
Can my baby recover after treatment? Will there be any effects on her? Also, I had my first blood test in April with an RPR of 1:32 and completed three doses of treatment.
In August, my RPR was 1:4.
However, last week, my blood test showed RPR 1:128 and TPPA skyrocketed to over 40,000.
My husband and I have not had sexual intercourse, and I have no other partners.
Why is this happening...?

yu, 20~29 year old female. Ask Date: 2023/11/01

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
Your question pertains to infectious diseases, and I recommend that you consult with an infectious disease specialist.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is here to support you.

Reply Date: 2023/11/01

More Info

Congenital syphilis is a serious condition that occurs when a mother with syphilis passes the infection to her baby during pregnancy. The implications for your newborn can be significant, and it's crucial to understand the potential effects, treatment options, and long-term outcomes.

When a baby is born to a mother with untreated syphilis, they may be at risk for a range of health issues. These can include low birth weight, premature birth, and a variety of congenital abnormalities. The symptoms of congenital syphilis can manifest in different ways, including skin rashes, fever, irritability, swollen liver or spleen, and jaundice. In severe cases, it can lead to more serious complications such as bone deformities, neurological issues, or even death.

In your case, the RPR (Rapid Plasma Reagin) test results indicate that your baby has been exposed to syphilis, but the levels you mentioned (RPR 1:4) suggest that the infection may not be severe. The hospital's recommendation for hospitalization is likely a precautionary measure to ensure that your baby receives appropriate care and monitoring. Treatment for congenital syphilis typically involves administering penicillin, which is highly effective in treating the infection. If your baby receives the appropriate treatment, there is a good chance of recovery without long-term effects.

Regarding your own RPR test results, the fluctuation in titers (from 1:32 to 1:4 and then to 1:128) can be confusing. It's important to note that RPR is a non-treponemal test, which means it can sometimes yield false positives or fluctuate due to various factors, including recent infections, autoimmune diseases, or even pregnancy. The TPPA (Treponema pallidum particle agglutination) test is more specific for syphilis and can help confirm the diagnosis. The high TPPA result you mentioned (over 40,000) indicates a strong presence of antibodies against the syphilis bacteria, suggesting that you have had a syphilis infection at some point.

It's also essential to communicate openly with your healthcare provider about your concerns, especially regarding the lack of sexual activity with other partners. They can provide clarity on how syphilis can be transmitted and discuss the implications for your health and your baby's health.
In summary, while congenital syphilis can have serious implications, timely treatment with penicillin can lead to a positive outcome for your newborn. Continuous follow-up with your healthcare provider is crucial to monitor both your health and your baby's progress. Make sure to attend all scheduled appointments and follow any recommendations provided by your medical team. They are best equipped to guide you through this process and address any concerns you may have.

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