Children Born with Syphilis Are Six Times More Likely to Require Early Hospitalization

Recent research highlights that children born with congenital syphilis face a significantly higher risk of hospital admission in their first five years of life—specifically, they are six times more likely to be hospitalized compared to children whose mothers were not infected during pregnancy. The study, which analyzed data from over 8 million children in Brazil, was published in JAMA Network Open and was conducted by researchers from the London School of Hygiene & Tropical Medicine (LSHTM) and the Center for Data and Knowledge Integration for Health (CIDACS).

Syphilis, a common sexually transmitted infection caused by the bacterium Treponema pallidum, can be transmitted from mother to fetus during pregnancy, leading to congenital syphilis. Despite being both preventable and treatable, syphilis remains a pressing public health issue worldwide, with estimates indicating 6 million new cases annually. The infection during pregnancy contributes to adverse outcomes such as stillbirth, preterm birth, and infant mortality. Survivors of congenital syphilis may suffer from lifelong disabilities including skeletal deformities, seizures, deafness, and severe infections.

The study found that children with congenital syphilis were six times more likely to be hospitalized before reaching five years old. Children exposed in utero but not diagnosed with the infection also faced doubled risks of hospitalization. The risk was especially pronounced in the first month of life—these infants were 11 times more likely to be hospitalized than unexposed babies.

Researchers used administrative data to track the health outcomes of children and identified significant disparities. The findings underscore that even when maternal syphilis is treated, the impact on child health persists, emphasizing the importance of comprehensive prevention, early diagnosis, and treatment strategies in pregnant women.

Dr. Enny Da Paixao Cruz, lead author and LSHTM Associate Professor, emphasized that syphilis infections, despite being preventable, continue to affect thousands of women and children yearly. She advocates for preventative measures that go beyond prenatal testing, focusing on reducing syphilis infections among women before pregnancy.

Professor Maria Yury Ichihara from CIDACS pointed out that the consequences of maternal syphilis extend well into childhood, with exposed children facing higher hospitalization risks even when congenital infection isn’t diagnosed. This highlights the need for enhanced screening, prevention, and supportive care to improve long-term outcomes.

The study notes limitations, including reliance on administrative data, which may lack detailed clinical information and be subject to misclassification. Nevertheless, the findings call for urgent public health interventions aimed at reducing the burden of syphilis and its impact on maternal and child health.

For more information, the full study can be accessed in JAMA Network Open: [https://dx.doi.org/10.1001/jamanetworkopen.2025.7471].