Surveillance of Gestational Syphilis in Brazil: A Decadal Analysis of Sociodemographic Aspects, Profile, and Clinical Forms (2014–2024)

Syphilis is a sexually transmitted bacterial infection, with primary, secondary, latent, and tertiary clinical stages. Its vertical transmission from pregnant women to the fetus constitutes gestational syphilis, responsible for severe perinatal outcomes. Early diagnosis and adequate prenatal care are essential for prevention. This study aimed to analyze the epidemiological profile of gestational syphilis in Brazil between 2014 and 2024, with emphasis on regional, sociodemographic, and clinical aspects. Descriptive study with a quantitative approach, using secondary data from DATASUS. Variables analyzed included region, race/skin color, age, education, and clinical forms of syphilis (primary and latent). Statistical analyses were performed using ANOVA and Tukey’s test, with p < 0.05 considered significant and 95% confidence intervals. A total of 626,880 cases of gestational syphilis were reported in Brazil between 2014 and 2024. The highest number of notifications occurred in 2023 (14.2%), followed by 2022 (13.9%) and 2021 (12.4%) (p = 0.4). The Southeast region accounted for most cases (46.2%), especially the state of Rio de Janeiro (30.8% of the national total), followed by the Northeast (20.8%) and South (14.9%) (p < 0.05). Most pregnant women were mixed-race (51.2%) or white (28.8%) (p < 0.05). Regarding age, most were 20–39 years (74.3%) and 15–19 years (22.7%) (p < 0.05). Regarding education, a high rate of missing data was observed (26.6%), followed by women with completed secondary education (22.7%). Clinically, the latent (38.1%) and primary (26.1%) forms were the most reported (p = 0.12). Among non-treponemal tests, 77.1% were reactive, while 13.2% of pregnant women did not undergo testing (p > 0.05). Among treponemal tests, 78.7% were reactive, and 11.8% were not performed (p < 0.05). The data show higher vulnerability among young and mixed-race women, along with underreporting and incomplete records, even among pregnant women with completed secondary education. These results reinforce the need to strengthen educational interventions and comprehensive prenatal care strategies, highlighting early and complete testing. The high positivity in treponemal tests underscores their importance in screening and diagnosis. Intensifying prevention campaigns and expanding access to qualified prenatal care are crucial.