Historical Trends and Epidemiological Indicators of Congenital Syphilis in São Paulo, Brazil: 1986-2023.

BACKGROUND: This study aimed to present historical trends and key epidemiological indicators of congenital syphilis in São Paulo, Brazil, from 1986 to 2023. METHODS: This retrospective cross-sectional study used secondary data. RESULTS: A total of 56,547 cases and 690 deaths from congenital syphilis were reported. The incidence rate steadily increased over time. The number of stillbirths and miscarriages also rose. Most cases of maternal syphilis infection were identified during prenatal care, and the rate of inadequate maternal treatment remained high. Partner treatment led to modest improvements. CONCLUSION: Despite improvements in prenatal care coverage and earlier diagnosis, the persistent rise in congenital syphilis incidence and mortality highlights ongoing gaps in maternal and partner treatment.