What complications are associated with untreated early syphilis in pregnancy?

Untreated early syphilis in pregnancy can lead to serious complications for both the mother and the fetus. One of the most significant outcomes is an increased risk of fetal demise and miscarriage. When a pregnant individual is infected with syphilis, the Treponema pallidum bacterium can cross the placenta, potentially leading to devastating consequences.

Fetal demise refers to the loss of a fetus in-utero after the 20th week of pregnancy, while miscarriage is the loss of a fetus before this point. Studies have shown that maternal syphilis is correlated with higher rates of these outcomes, particularly when the infection is untreated. The risk increases with the duration of the syphilis being unresolved, particularly in cases of early syphilis, making it crucial for pregnant individuals to receive screening and treatment.

In contrast, while complications such as placental issues and preterm birth can occur in certain circumstances, they are not as directly linked to early syphilis as fetal demise and miscarriage are. Therefore, the identification of fetal demise and miscarriage as primary complications underscores the critical importance of timely diagnosis and treatment of syphilis in pregnant individuals to mitigate these risks.