Congenital syphilis in Brazil: a study on incidence, epidemiological profile, treatment and maternal vulnerabilities (2007–2023)

Abstract

Congenital syphilis, a vertical infection caused by Treponema pallidum, can lead to neonatal complications such as stillbirth and congenital malformations. Despite the availability of effective prevention methods, including early diagnosis and proper management during prenatal care, the incidence of the disease remains high in Brazil. This ecological study analyzed the epidemiological profile of congenital syphilis in the country between 2007 and 2023, using data from the Ministry of Health’s Epidemiological Profile platform. Variables such as case numbers by region, timing of diagnosis, therapeutic approach, age, race/color, and education level of pregnant women were evaluated. Between 2007 and 2023, there was a significant increase in cases and incidence rate, from 2.0% to 9.9%. The Southeast and Northeast regions accounted for the majority of cases, especially in the states of Rio de Janeiro and São Paulo. Despite increased prenatal care coverage, most diagnoses occurred at delivery, complicating prevention of vertical transmission. Approximately 80% of pregnant women did not receive adequate treatment or were untreated. The profile of pregnant women showed a predominance of brown-skinned, young women (15 to 39 years old) with low education levels, although there was a proportional increase among those with secondary and higher education. The results highlight the need to strengthen public policies focused on prevention, early diagnosis, and management of syphilis, with special attention to prenatal care and social vulnerabilities.