Syphilis in Pregnancy

Congenital Syphilis at a Glance

  • Syphilis is a curable infection, but most people do not know they have it until they get tested
  • Syphilis can be spread from mother to baby at any time during pregnancy
  • If you are pregnant and have syphilis, you can reduce the risk of congenital syphilis by getting tested and treated as soon as possible
  • Every pregnant person should be tested for syphilis at least three times during pregnancy: at their first prenatal care visit, at the start of their 3rd trimester (no later than 32 weeks), and at delivery

What is Congenital Syphilis?

Syphilis is an infection that is spread through sex. Signs and symptoms are commonly missed so many do not know they have it until they are tested. Syphilis can be passed from a mother to a baby during pregnancy- this is called congenital syphilis.

Congenital syphilis can cause serious health effects such as miscarriage, stillbirth, premature birth, birth defects, or even infant death. Some babies born with congenital syphilis may appear healthy at birth, but start having serious health problems as they get older

How common is congenital syphilis in Hawaiʻi?

Syphilis is on the rise in Hawaiʻi:

  • There were 6x more congenital syphilis cases reported in Hawaiʻi in 2021 than in 2017
  • From 2017-2021, nearly 1 in 5 babies were stillborn among congenital syphilis cases reported in Hawaiʻi
  • In 2021, Hawaiʻi was ranked 10th highest in the country for congenital syphilis case rates (128 cases per 100,000 live births)

Am I at risk of getting syphilis and passing it on to my baby?

Anyone who has sex (vaginal, anal, and/or oral sex) can get syphilis. However, you cannot get syphilis through everyday contact with others, such as sitting on toilet seats, swimming in public pools, or sharing food or drinks.

Most people who have syphilis don’t know it – you can have syphilis even if you don’t notice any symptoms. If you are pregnant or thinking about becoming pregnant, the only way to know if you have syphilis is by getting tested.

What can I do to protect myself and my baby?

Your baby will not get congenital syphilis if you do not have syphilis. If you have syphilis while you are pregnant, treating yourself is also treating your baby.

  • GET TESTED – start prenatal care and get tested for syphilis as early as possible during your pregnancy
  • GET TREATED – if you are diagnosed with syphilis you will need to be treated right away. The sooner you can get treated, the better the chances are of stopping serious health problems from happening to you and your baby
  • GET YOUR PARTNERS TESTED AND TREATED – you can get syphilis and other STIs more than once if your sex partner(s) are untreated. Tell your sex partner(s) to see a healthcare provider to get tested and treated.

What is the treatment for syphilis?

If you are diagnosed with syphilis during pregnancy, the treatment to cure syphilis is penicillin given as a shot in each buttock.
Your healthcare provider will tell you if you need just one dose on one day or three doses given one week apart.

If you need to have three doses of penicillin, do not miss any appointment or you might have to restart the treatment from the beginning.


Getting treatment does not prevent you from from getting syphilis again during pregnancy, so it is important that your sex partner(s) receive treatment too.

My baby was born with congenital syphilis. Is there a way to treat the infection?

Yes, babies who are born with congenital syphilis need to be treated right away or they can develop serious health problems.
Depending on the results of your baby’s syphilis testing, they may need antibiotics in a hospital over 10 days. Sometimes, only one shot of antibiotic is needed.