What does this research mean for the field?

Serologic screening of newborns for syphilis at delivery misses a substantial proportion of at-risk infants compared to maternal screening, demonstrating that mothers rather than infants should be tested to prevent congenital syphilis. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To determine whether maternal or newborn serologic testing at delivery provides superior identification of infants at risk for congenital syphilis.

August 30, 2026Journal of the Pediatric Infectious Diseases SocietyOpen Access

Serologic Screening for Syphilis at Delivery: Mother or Infant?

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Authors

SCSameer B. ChandNationwide Children's Hospital SMSebastian MartinezNationwide Children's Hospital TPTraci PiferNationwide Children's Hospital

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Implication

Retrospective study finds nonreactive newborn testing in one-third of exposed cases, suggesting maternal screening at delivery is essential.

Key Points

To determine whether maternal or newborn serologic testing at delivery provides superior identification of infants at risk for congenital syphilis.
Retrospective review of 513 mother-infant dyads referred to a pediatric infectious disease clinic between January 1, 2002, and December 31, 2024.
Mothers with reactive serologic tests for syphilis were evaluated alongside their newborns using electronic health records and public health registry data.
Paired maternal and infant rapid plasma reagin (RPR) titers and treatment regimens were compared.
Among 513 mother-infant dyads, 33% of infants (170/513, born to 168 mothers) had a nonreactive RPR at birth despite positive maternal serology at delivery.
Of the 168 discordant mothers, the median maternal RPR titer was 1:4 (IQR: 1:2–1:16), 67% (n=112) had syphilis of unknown duration, and 26% (n=44) were untreated at delivery.
None of the 170 infants exhibited clinical signs of congenital syphilis at birth, but 54% (92/170) required treatment with intramuscular benzathine penicillin G based on maternal infection history.

Cite This Study

Chand et al. (2026) studied this question.

synapsesocial.com/papers/6a93f1396c1a8fb52e79df4b https://doi.org/10.1093/jpids/piag070/piag070.027

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Implication

Retrospective study finds nonreactive newborn testing in one-third of exposed cases, suggesting maternal screening at delivery is essential.

Serologic Screening for Syphilis at Delivery: Mother or Infant?

Discussion

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Implication

Key Points

Cite This Study

Serologic Screening for Syphilis at Delivery: Mother or Infant?

Discussion

Member takes

Implication

Key Points

Cite This Study

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