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Evaluations and Treatment Among Infants Exposed to Syphilis in Utero, Six U.S. States, 2018-2021

Mundayi V Nlandu1, Elizabeth L Lewis2, Jeffrey M Carlson2

  • 1Oak Ridge Institute for Science and Education, 1299 Bethel Valley Road, Oak Ridge, TN 37830, United States.

Journal of the Pediatric Infectious Diseases Society
|February 14, 2026
PubMed

Insights

Management of infants exposed to syphilis in utero shows inconsistent adherence to guidelines. This analysis of surveillance data highlights gaps in recommended evaluations and treatments for these vulnerable newborns.

Area of Science:

  • Neonatal health
  • Infectious disease epidemiology
  • Public health surveillance

Background:

  • Syphilis in utero poses significant risks to newborns.
  • Current data on the management of exposed infants are scarce.
  • Standardized guidelines exist for infant evaluation and treatment.

Purpose of the Study:

  • To describe the current management practices for infants exposed to syphilis during gestation.
  • To identify variations in the implementation of established clinical guidelines.
  • To assess the consistency of care for congenital syphilis exposure.

Main Methods:

  • Analysis of population-based public health surveillance data.
  • Retrospective review of infant case management records.
  • Examination of evaluation and treatment protocols followed.

Main Results:

  • Significant inconsistencies were observed in the application of recommended guidelines.
  • Variability exists in the diagnostic evaluations performed on exposed infants.
  • Treatment adherence to established protocols is not uniformly implemented.

Conclusions:

  • Current practices for managing infants exposed to syphilis in utero are suboptimal.
  • There is a critical need for improved adherence to evidence-based guidelines.
  • Enhancing consistent care is essential to prevent adverse outcomes of congenital syphilis.

Keywords:
STI treatment guidelinescongenital infectioncongenital syphilispublic healthsurveillance

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