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Risk factors and diagnostic indicators for congenital syphilis: a Nationwide retrospective survey

Hiroyuki Shimizu1, Munehiro Furuichi2, Noriko Takeuchi3

  • 1Department of Clinical Laboratory Medicine, Fujisawa City Hospital, Kanagawa, Japan.

Epidemiology and Infection
|October 22, 2025
PubMed

Insights

Delayed maternal syphilis treatment and elevated infant IgM levels are key risk factors for congenital syphilis (CS). Infant

Area of Science:

  • Obstetrics and Gynecology
  • Pediatrics
  • Infectious Diseases

Background:

  • Congenital syphilis (CS) poses significant risks to newborns.
  • Accurate diagnosis and identification of risk factors are crucial for effective management.

Purpose of the Study:

  • To identify risk factors for congenital syphilis (CS).
  • To evaluate diagnostic indicators for CS.
  • To enhance diagnostic accuracy for CS in infants.

Main Methods:

  • Nationwide retrospective study in Japan (2015-2024).
  • Analysis of data from 230 pregnant women and their infants.
  • Multivariable logistic regression to identify risk factors.
  • Evaluation of infant rapid plasma reagin (RPR) titres and infant-to-mother RPR ratio.

Main Results:

  • Delayed maternal treatment (>4 weeks before delivery) was a significant risk factor (OR: 7.20).
  • Elevated infant total IgM levels (>20 mg/dL) were strongly associated with CS (OR: 65.31).
  • Infant RPR titre ≥1 demonstrated high sensitivity (93.8%) as a diagnostic indicator.

Conclusions:

  • Delayed maternal treatment and high infant IgM levels are significant risk factors for CS.
  • Infant RPR titre is a valuable diagnostic indicator for congenital syphilis.
  • Improved diagnostic strategies can enhance outcomes for infants at risk of CS.

Keywords:
Total IgMcongenital syphilismaternal syphilisrapid plasma reaginrisk factor

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