CoChat
Sign Up
Cited by 2Syphilis Diagnosis and TreatmentNeonatal and Maternal InfectionsHistorical Medical Research and Treatments

Diagnosis and management of syphilis infection in pregnancy: a literature review

Open access
Winata, I Gde Sastra, Setiawan, William Alexander, Widhusadi, Ni Luh Wita Astari, Maharddhika, DPG Jananuraga, Christyani, Fenyta, Darmayasa, Putu Bagus, Halim, Anthony Stephen, Sianturi, Ernest TB·2023·Indonesian Journal of Perinatology
DOI 10.51559/inajperinatol.v4i1.28
Open this paper in CoChat — free accountOpen PDF

Abstract

Treponema pallidum, which causes the infectious disease syphilis, has a high rate of vertical transfer from mother to kid. Untreated maternal infection increases the risk of perinatal morbidity and mortality and unfavorable pregnancy outcomes, notably congenital syphilis. It is necessary to check for gestational syphilis during the prenatal period, and its diagnosis is straightforward. Nevertheless, this illness still affects two million pregnant women globally, indicating its significant prevalence. Congenital syphilis clinical symptoms are regulated by gestational age, maternal syphilis stage, maternal therapy, and fetus immune response. Early and late congenital syphilis have historically been used to describe it. The direct identification of treponemes, serological tests, and clinical signs all contribute to the diagnosis of maternal infection. Penicillin is typically used in the treatment, which also includes sexual partners. Fetal infection can be treated and prevented from spreading from the mother to the fetus with proper maternal infection management. To lower the prevalence of congenital syphilis, screening, early detection, and appropriate care are crucial during pregnancy and the preconception period.

Integrity signals

Registry

Crossref · 10.51559/inajperinatol.v4i1.28

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 39 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Mother-to-child transmission of syphilis during pregnancy can majorly affect the fetus in the second or third trimester and cause complications, particularly congenital infections in newborns.

    “Syphilis transmitted from mother to child (MTCT) during pregnancy can majorly affect the fetus in the second or third trimester and cause complications, particularly congenital infections in newborns.12”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [12] 12. Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013/01/17. 2013;91(3):217-26. Available in: https://pubmed.ncbi.nlm.nih. gov/23476094 source

      The Introduction (p. 1) says untreated syphilis during pregnancy can cause fetal loss, stillbirth, and congenital syphilis in liveborn infants; the findings (p. 1) report clinical evidence of congenital syphilis in 15% of infants of mothers with untreated syphilis. The copy does not support the claim's specific second- or third-trimester timing. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    Infection with T. pallidum during pregnancy is especially dangerous because the fetus can acquire it through the placenta.

    “is especially dangerous during pregnancy due to the possibility of the fetus contracting the infection through the placenta.1”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] 1. Berman SM. Maternal syphilis: pathophysiology and treatment. Bull World Health Organ. 2004;82(6):433-8.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Premisecitation

    Treponemal tests cannot distinguish T. pallidum infection from other treponemal infections.

    “This test also cannot distinguish T. pallidum infection from other treponemal infections.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Premisecitation

    Without screening and treatment, about 70% of syphilis-infected pregnant women will have an adverse pregnancy outcome.

    “Without screening and treatment, about 70% of infected women will have an adverse pregnancy outcome.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] 5. Hawkes S, Matin N, Broutet N, Low N. Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis. Lancet Infect Dis. 2011;11(9):684-91. Available in: http://dx.doi. org/10.1016/s1473-3099(11)70104-9 source
  • Premisecitation

    When durum and condylomata lata ulcers are present, dark-field microscopic examination for T. pallidum is the most accurate and specific test.

    “When durum and condylomata lata ulcers are present, a direct examination for T. pallidum bacteria under a dark field microscope is the most accurate and specific test.21,22”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] 21. Darmawan H, Purwoko IH, Devi M. Sifilis Pada Kehamilan. Sriwij J Med. 2020;3(1):73-83. Available in: http://dx.doi.org/10.32539/sjm. v3i1.70 source
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. 8
  • May combine two claims. 14

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Treponema pallidum is the bacterium that causes syphilis.

    “Treponema pallidum, the bacteria that causes the sexually transmitted disease (STD) syphilis”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] 1. Berman SM. Maternal syphilis: pathophysiology and treatment. Bull World Health Organ. 2004;82(6):433-8.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Non-treponemal tests are cheaper than treponemal-specific tests and are therefore often used for screening.

    “Because this non-specific test is much cheaper than the treponemal-specific test, it is often used for screening.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Syphilis during pregnancy can spread to the fetus and cause miscarriage, early birth, low birth weight, stillbirth, or congenital syphilis.

    “Syphilis during pregnancy can spread to the fetus, resulting in miscarriage, early birth, low birth weight, stillbirth, or congenital syphilis.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] 21. Darmawan H, Purwoko IH, Devi M. Sifilis Pada Kehamilan. Sriwij J Med. 2020;3(1):73-83. Available in: http://dx.doi.org/10.32539/sjm. v3i1.70 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The incubation period of syphilis can last 3-12 weeks.

    “The incubation period can last for 3-12 weeks.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Serological tests for syphilis are divided into non-treponemal and treponemal tests.

    “Serological tests are divided into non-treponemal and treponemal tests.21,22”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] 21. Darmawan H, Purwoko IH, Devi M. Sifilis Pada Kehamilan. Sriwij J Med. 2020;3(1):73-83. Available in: http://dx.doi.org/10.32539/sjm. v3i1.70 source
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Most infants with congenital syphilis are infected in utero, but they can also acquire the disease by touching an active genital lesion during birth.

    “Most infants with congenital syphilis are infected while still in the womb, but the baby can also contract the disease by touching an active genital lesion when the mother is giving birth.17,18”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [17] 17. Berger JR. Neurosyphilis in Human Immunodeficiency Virus Type 1-Seropositive Individuals. Arch Neurol. 1991;48(7):700. Available in: http://dx.doi.org/10.1001/ archneur.1991.00530190046014

      Not checked in the free run.

    • cites [18] 18. Jaffe HW. Tests for Treponemal Antibody in CSF. Arch Intern Med. 1978;138(2):252. Available in: http://dx.doi.org/10.1001/ archinte.1978.03630260050016

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Penicillin levels in blood remain treponemicidal for weeks, but penicillin does not effectively cross the blood-brain barrier.

    “Penicillin levels in the blood are treponemicidal for weeks, although it is ineffective at crossing the blood-brain barrier.24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 24. ALEXANDER JM, SHEFFIELD JS, SANCHEZ PJ, MAYFIELD J, WENDEL GD. Efficacy of Treatment for Syphilis in Pregnancy. Obstet & Gynecol. 1999;93(1):5-8. Available in: http://dx.doi.org/10.1097/00006250- 199901000-00002 source

  • May combine two claims.

    Premisecitation

    Congenital syphilis and mother-to-child transmission can be prevented by early detection and treatment of syphilis in pregnant women.

    “Congenital syphilis can be avoided, and mother-to-child transmission of the disease can be stopped by using successful early detection and treatment methods for syphilis in pregnant women.6”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] 6. Benzaken AS, Sabidó M, Galban E, Pedroza V, Araújo AJG, Peeling RW. Field performance of a rapid point-of-care diagnostic test for antenatal syphilis screening in the Amazon region, Brazil. Int J STD & AIDS. 2011;22(1):15- source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Syphilis is the second most frequent infectious cause of stillbirth worldwide and a significant, avoidable contributor to infant morbidity and mortality.

    “The second most frequent infectious cause of stillbirth worldwide is syphilis, a significant contributor to infant morbidity and mortality that can be easily avoided.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] 10. Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587-603. Available in: http:// dx.doi.org/10.1016/s0140-6736(15)00837-5 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The rash of secondary syphilis (roseola syphilitic) is an erythematous maculopapular lesion 0.5 to 1 cm in diameter that does not itch on the body or extremities.

    “The rash, frequently called roseola syphilitic, is an erythematous maculopapular lesion with a diameter of 0.5 to 1 cm that does not itch on the body or extremities.21, 22”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] 21. Darmawan H, Purwoko IH, Devi M. Sifilis Pada Kehamilan. Sriwij J Med. 2020;3(1):73-83. Available in: http://dx.doi.org/10.32539/sjm. v3i1.70 source
    • cites [22] 22. Giovani V. Infeksi Sifilis Pada Kehamilan. Universitas Udayana; 2016. Available in: http:// erepo.unud.ac.id/id/eprint/10815/1/2779 dd5ac821e2be846467e464c72db5.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Between 2012 and 2016, congenital syphilis declined globally while maternal syphilis prevalence remained steady.

    “Between 2012 and 2016, there was a global decline in congenital syphilis, but maternal prevalence remained steady.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] 11. Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesooriya NS, Mahiané SG. Correction: Global burden of maternal and congenital syphilis and associated adverse birth outcomes- Estimates for 2016 and progress since 2012. PLoS One. 2019;14(7):e0219613-e0219613. Available in: https://pubmed.ncbi.nlm.nih. gov/31276484 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Updated 2012 estimates were 748,000 congenital syphilis cases (539 per 100,000 live births), 397,000 unfavorable birth outcomes, and maternal prevalence 0.70% (95% CI 0.63-0.77%).

    “According to the updated 2012 estimates, there were 748,000 congenital syphilis cases (539 per 100,000 live births), 397,000 unfavorable birth outcomes, and 0.70 percent (95% CI: 0.63-0.77%)mother prevalence.11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] 11. Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesooriya NS, Mahiané SG. Correction: Global burden of maternal and congenital syphilis and associated adverse birth outcomes- Estimates for 2016 and progress since 2012. PLoS One. 2019;14(7):e0219613-e0219613. Available in: https://pubmed.ncbi.nlm.nih. gov/31276484 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In 2016, estimated global maternal syphilis prevalence was 0.69% (95% CI 0.57-0.81), with 661,000 congenital syphilis cases, 355,000 adverse birth outcomes, 306,000 non-clinical congenital syphilis cases, and a congenital syphilis rate of 473 per 100,000 live births.

    “With a global congenital syphilis rate of 473 per 100,000 live births and 661,000 total congenital syphilis cases, including 355,000 adverse birth outcomes and 306,000 non-clinical congenital syphilis cases (infants born to untreated mothers without clinical signs), the estimated global maternal syphilis prevalence in 2016 was 0.69% (95% CI: 0.57-0.81%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] 11. Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesooriya NS, Mahiané SG. Correction: Global burden of maternal and congenital syphilis and associated adverse birth outcomes- Estimates for 2016 and progress since 2012. PLoS One. 2019;14(7):e0219613-e0219613. Available in: https://pubmed.ncbi.nlm.nih. gov/31276484 source

  • May combine two claims.

    Interpretationreasoning

    Fetal infection can be treated and prevented from spreading from mother to fetus with proper maternal infection management.

    “Fetal infection can be treated and prevented from spreading from the mother to the fetus with proper maternal infection management.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    If a pregnant woman receives proper syphilis care early, ideally before the second trimester, the fetus can be treated and the chance of negative outcomes is reduced.

    “If the mother obtains proper care in the early stages of pregnancy, ideally before the second trimester, the fetus can be easily treated, and the chance of negative outcomes is limited.6”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] 6. Benzaken AS, Sabidó M, Galban E, Pedroza V, Araújo AJG, Peeling RW. Field performance of a rapid point-of-care diagnostic test for antenatal syphilis screening in the Amazon region, Brazil. Int J STD & AIDS. 2011;22(1):15- source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    Infection with syphilis during pregnancy remains a serious public health issue worldwide, especially in Indonesia.

    “Infection with syphilis during pregnancy is still a serious public health issue worldwide, especially in Indonesia.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Low- and middle-income countries, particularly Indonesia, carry the largest syphilis disease burden.

  • May combine two claims.

    Interpretationnone given

    Penicillin is an effective treatment for syphilis and can prevent congenital syphilis.

    “Penicillin, a powerful medication used to prevent congenital syphilis, is an effective treatment for syphilis and can be used to detect the condition with minimal expense.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    If delivery occurs within 30 days of therapy or if maternal antibody titer at delivery is four times higher than pre-treatment titer, maternal treatment may be insufficient.

    “If delivery occurs within 30 days of therapy or if the maternal antibody titer at delivery is four times higher than the pre-treatment titer, maternal treatment may not be sufficient.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] 25. World Health Organization. Syphilis screening and treatment for pregnant woman. Geneva: World Health Organization; 2017. Available in: https://apps.who.int/iris/rest/ bitstreams/1088912/retrieve

      Not checked in the free run.

18 of 18

  • The paper relies on this without support.

    Low- and middle-income countries, particularly Indonesia, carry the largest syphilis disease burden.

    “Lowand middle-income countries, particularly Indonesia, have the largest disease burden.”

  • The paper relies on this without support.

    Diagnosis of gestational syphilis is straightforward.

    “It is necessary to check for gestational syphilis during the prenatal period, and its diagnosis is straightforward.”

  • The paper relies on this without support.

    Increased access to prenatal care, syphilis screening, and treatment contributed to the decline in congenital syphilis case rates between 2012 and 2016.

    “Increased access to prenatal care (ANC), syphilis screening, and treatment are believed to have contributed to the estimated decline in congenital syphilis case rates between 2012 and 2016.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Single-dose treatment is both recommended and described as ineffective for latent syphilis

    Minor

    The paper recommends a single dose of benzathine penicillin for early latent syphilis, but later says mothers with latent syphilis are unaffected by single-dose parenteral penicillin. Early latent syphilis falls within the group the later statement excludes.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. [4]4. Ingall D, Sanchez P, Musher D. Syphilis. :يف Remington J, Klein J. Infectious diseases of the fetus & newborn. Philadelphia: WB Saunders Company; 2001. 643-81.
  2. [8]8. Available in: http://dx.doi.org/10.1258/ ijsa.2010.010145
  3. [16]16. Stokes J, Beerman H, Ingraham N. Modern Clinical Syphilology: Diagnosis, Treatment, Case Study. 3rd Editio. Philadelphia: WB Saunders Company; 1944.

Cited by

Sorted by citations

Related

Authors
Winata, I. G. S., Setiawan, W. A., Widhusadi, N. L. W. A., Maharddhika, D. J., Christyani, F., Darmayasa, P. B., Halim, A. S., & Sianturi, E. T.
Affiliations
Udayana University (ID)
ORCID
Venue
Indonesian Journal of Perinatology
Publisher
Sanglah Hospital - Udayana University
Published
2023-02-10
Volume
4
Issue
1
Pages
10-14
ISSN
  • 2775-0736 (ISSN-L)
  • 2775-0744
DOI
10.51559/inajperinatol.v4i1.28
OpenAlex
W4386868598
Semantic Scholar
df4898e8069847d173f01c891eea0b0f8495ab76
Cited by
2
References
22
Citations by year
2026: 1 · 2025: 1
FWCI
0.36
Type
journal article
Language
en
Open access
Locations
Indonesian Journal of Perinatology (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
Keywords
maternal syphilis, Treponema pallidum, vertical transmission, congenital syphilis, prenatal screening, serological diagnosis, penicillin therapy, partner treatment, perinatal morbidity and mortality, pregnancy outcomes

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review