From January 1, 2009 through December 31, 2011, from 33,753 blood samples for
syphilis screening, Treponema pallidum
infections were confirmed in 241 pregnant women at the Department of Dermatology, Venerology, and Dermatooncology of Semmelweis University Budapest. In this period, four children born to inadequately or untreated women were confirmed to have connatal
syphilis. The height of rapid plasma
reagin (RPR) titer was measured to determine the stage of the
infection and to examine the success of the antilues
therapy. The diagnosis of maternal
syphilis infection was confirmed with
enzyme linked
immunosorbent assay (ELISA), T. pallidum particle agglutination (TPPA), and
IgG and
IgM immunoblots. Maternal
IgM immunoblot results identify mothers at risk of delivering babies with connatal
syphilis better than the height of maternal RPR titer. The standard serological tests are less useful in newborns because of
IgG transfer across the placenta.
IgM test which depends on the infant's response has more specificity in diagnosing connatal
syphilis.