*4.2.3.1.1 Congenital syphilis*

Maternal risk factors for syphilis during pregnancy include sex with multiple partners, sex in conjunction with drug use or transactional sex, late entry to prenatal care or no prenatal care, methamphetamine or heroine use, incarceration of the woman or her partner, and unstable housing or homelessness.

All neonates born to mothers who have reactive non-treponemal and treponemal test results should be evaluated with quantitative non-treponemal serologic test performed on the neonate's serum (umbilical cord blood has to be avoided due to the presence of maternal blood), and Wharton's jelly could lead to a false-negative result.


*\*And one of the following: mother was not treated (inadequately or not documented), mother was treated with erythromycin or a non-penicillin G regimen, mother with an adequate treatment but started <30 days before delivery. \*\*And both of the following are true: Mother was treated adequately for infection stage during pregnancy, and treatment was started* ≥*30 days before delivery, and mother has no evidence of reinfection or relapse.\*\*\*And both of the following are true: mother's treatment was adequate before pregnancy, and the mother's non-treponemal serologic titer remained low and stable before and ruing pregnancy and at delivery.*
