To investigate the clinical characteristics, diagnosis, comorbidities and prognosis of neonatal congenital syphilis (CS).

Clinical data of newborn children with congenital syphilis admitted to the Department of Pediatrics of Beijing Ditan Hospital, Capital Medical University from January 2014 to December 2021: gender, gestational age, birth weight, mode of delivery, age of onset, age of diagnosis, length of hospital stay, maternal syphilis infection and treatment, clinical manifestations, laboratory examination on admission, complications, treatment and prognosis were retrospectively analyzed. According to the mother’s treatment during pregnancy, they were divided into incomplete treatment group (6 cases) and untreated group (50 cases). SPSS 22.0 was used for data analysis. The measurement data conforming to normal distribution were described by mean ± standard deviation and comparison between groups was performed by t test. Measurement data that did not conform to normal distribution were described by [M (P25, P75)], and rank sum test was used for comparison between groups. Statistical data were represented by the number of cases (%), χ² test was used for comparison among groups, and P < 0.05 was considered significant difference.

Total of 56 cases of congenital syphilis were included in this study, including 32 males (57.1%) and 24 females (42.9%); 22 preterm infants (39.3%) and 34 full-term infants (60.7%). The transmission route of 56 cases of congenital syphilis children was mother-to-child transmission, and their mothers were all infected with syphilis. All pregnant women did not carry out standard plum exorcism treatment. The top 6 clinical manifestations were rash/large peeling (64.3%), yellow skin (33.9%), vomiting/poor appetite/abdominal distension (28.6%), edema (23.2%), fever (17.9%), liver and spleen enlargement (17.9%); 53 cases (94.6%) had complications, including 38 cases (67.9%) of anemia, 27 cases (48.2%) of elevated myocardial enzymes, 27 cases (48.2%) of abnormal liver function, 26 cases (46.4%) of hypoproteinemia, 18 cases (32.1%) of bone syphilis, 16 cases (28.6%) of thrombocytopenia. There were 14 cases of neurosyphilis (25%), 12 cases of pneumonia (21.4%), 6 cases of syphilitic nephritis (10.7%), 4 cases of sepsis (7.1%) and 3 cases of syphilitic rhinitis (5.4%). After the symptomatic treatment of active plum removal, liver protection, gallbladder and blood transfusion, 53 cases were discharged from hospital. There were 3 cases in critical condition at admission, whose families gave up treatment, and they died shortly after discharge.

The clinical manifestations of congenital syphilis in newborns are atypical and can be complicated with multiple organ systems damage. Skin damage is the most common manifestation. For children with syphilis infection and unknown infection status during pregnancy, etiological examination should be improved as soon as possible to achieve early diagnosis and treatment in order to obtain a good prognosis.