What to Know About Having Syphilis During Pregnancy

Syphilis can be passed to your baby during pregnancy. It can also contribute to the chance of complications during pregnancy, such as preterm labor or miscarriage.

Aside from problems related to the growth and development of an unborn baby, individuals with syphilis during pregnancy may also develop symptoms depending on the stage of the syphilis infection:

First stage or primary syphilis

In the first or primary stage of a syphilis infection, symptoms can include sores on areas of the body, such as the:

• vulva
• vagina
• cervix
• anus
• rectum
• tongue
• lips

Symptoms of infection at this stage usually develop 10–90 days after exposure to the bacteria and can last for 3–6 weeks. Syphilis that isn’t treated in stage 1 can progress to stage 2.

Second stage or secondary syphilis

The second stage of syphilis begins when the original sores begin to heal and a rash begins to form. These non-itchy rashes appear as rough, reddish-brown spots on the:

• stomach
• chest
• palms of your hands
• soles of your feet

Aside from the rash, other symptoms that can appear in the secondary stage include:

• mouth sores
• swollen glands
• fever
• hair loss
• headaches
• muscle aches
• weight loss
• fatigue

Inactive or latent stage

The inactive stage of syphilis begins when active sores and rashes clear up. It may seem like the infection is over, but in reality, it goes into an inactive phase that can last for many years.

You may not have noticeable symptoms during this time, but the infection remains in your body. Symptoms can reappear later in life, and the infection could progress.

Late or tertiary stage

Without treatment, syphilis can move to the late or tertiary stage. At this point, symptoms move beyond sores and rashes to more serious organ damage. It can affect any organ and may lead to:

• nerve problems
• blindness
• deafness
• paralysis
• dementia
• death

Symptoms of syphilis during pregnancy depend on the stage of the infection. If you were never diagnosed with syphilis and your symptoms cleared, you could be in the inactive stage with no noticeable symptoms at the time you become pregnant.

Syphilis can have severe and dangerous effects on an unborn baby, though, so syphilis testing at the start of pregnancy is important. Early testing can help identify latent and active infections that could put your baby at risk. In fact, this testing is so important that it’s mandatory in most states, and a doctor will carry out this test at your very first prenatal appointment.

Syphilis infections cause symptoms in everyone, but for unborn babies, the effects of the disease can be catastrophic. Up to 40% of babies born to individuals who have syphilis and go through pregnancy untreated may be stillborn or die due to the infection shortly after birth.

Some problems associated with a congenital syphilis infection can include:

• bone damage
• severe anemia
• enlarged liver
• enlarged spleen
• jaundice
• nerve damage
• blindness
• deafness
• meningitis
• skin rashes

Syphilis in pregnancy is treated with the antibiotic penicillin. The dose, timing, and duration of treatment depend on the stage of the disease at the time of diagnosis and how much time is left in the pregnancy before delivery. Treatment should be started at least 30 days before delivery.

Any sexual partners of individuals who receive a diagnosis of syphilis during pregnancy should also be treated to prevent reinfection.

During pregnancy, syphilis is passed to the baby in about 80% of cases, and babies born with congenital syphilis will be with penicillin as well. Treatment usually lasts for about 2 weeks.

For people with penicillin allergies, other antibiotics like cephalosporin or amoxicillin may be used, but penicillin is the preferred choice, if possible.

Treated early and effectively, a syphilis infection can be cured. However, any complications or damage caused by the infection — such as nerve damage — will not resolve after treatment. Any complications resulting from the infection are likely to be permanent.

The same is true for babies. Babies who are born with congenital syphilis who are not effectively treated in the first 3 months of life are likely to have lifelong complications like deafness, blindness, or cognitive delays.

What happens if you have syphilis when you become pregnant?

If you have an active or inactive or latent syphilis infection when you become pregnant, the infection may be passed to your unborn baby. The Centers for Disease Control and Prevention (CDC) recommends syphilis testing as a part of every initial prenatal appointment to ensure treatment can be started as soon as possible.

Will I test positive for syphilis forever?

When treated effectively, syphilis infections can be cured. If you recover from the early stages of the infection without treatment and remain in the latent phase, you can still test positive for syphilis, and you may develop another active infection later.

Is syphilis 100% curable?

Syphilis can be cured with the proper treatment, but treatment can’t undo any complications caused by the infection, such as blindness or nerve damage. Treatment and infection also won’t protect you from being infected again.

Should I be worried if I have syphilis?

Untreated syphilis can cause severe health problems and even death. It’s also a disease that is easily passed from parent to baby during pregnancy and can cause low birth weight, stillbirth, and miscarriage. Regular testing for STIs can help you get a quick diagnosis and fast treatment of syphilis and other STIs.

Syphilis is an STI with serious health consequences. Effective treatment can cure this infection, but even inactive infections can be passed to sexual partners and to babies while in the womb. Babies with prenatal syphilis infections can experience complications at birth or lifelong health problems if the infection is left untreated.

Talk with your healthcare team about regular testing for STIs and, if needed, what treatments are right for you.