Syphilis Complicating Pregnancy and Congenital Syphilis

( N Engl J Med . 2024;390(3):242–253) Congenital syphilis primarily occurs when the bacterium Treponema pallidum passes from an infected mother to her fetus through the placenta, and it continues to have significant global repercussions. Despite a decline in primary and secondary syphilis cases in the United States after 1990, reaching a low point in 2001, rates have since risen among both men and women of reproductive age, as well as among infants. In 2021, the rate of congenital syphilis in the United States reached its highest level in nearly 3 decades. This increase in cases is particularly evident in populations with limited access to health care.