Congenital syphilis is an infection caused by Treponema pallidum transmitted vertically during pregnancy or childbirth. It presents a broad clinical spectrum, potentially leading to stillbirth, prematurity, bone malformations, blindness, deafness, neurological impairment, and neonatal death. Given its public health importance, this study aimed to analyze congenital syphilis cases in Brazil, emphasizing temporal trends and regional disparities.

Retrospective study based on data from Brazil’s Ministry of Health Syphilis in Pregnant Women and Congenital Syphilis Monitoring Panel. Variables analyzed included age at diagnosis, reporting state, and clinical outcomes from 2007 to 2023.

During the period analyzed, the Southeast region accounted for 129,477 cases (43.49%), with Rio de Janeiro reporting 52,967 notifications. Regarding outcomes, 86.61% of newborns were alive, 1.57% died due to the condition, 4.18% resulted in miscarriage, and 3.23% were stillbirths. In the South, 37,489 cases (12.59%) were recorded, with Rio Grande do Sul reporting the highest number (21,883). Of these, 87.33% were alive, 1.42% died, 5.17% resulted in miscarriage, and 2.73% were stillbirths. In the Northeast, 88,377 cases (29.68%) were identified, led by Pernambuco (22,133 cases). Among them, 86.5% of newborns were alive, 1.76% died, 3% were miscarriages, and 3.35% stillbirths. The Center-West recorded 16,601 cases (5.58%), with Goiás contributing 6,276. Of these, 86.54% were alive, 1.59% died, 2.78% miscarried, and 3.28% were stillbirths. The North region registered 25,681 cases (8.62%), with Pará reporting 11,607. In this region, 90.3% of newborns were alive, 1.34% died, 1.80% miscarried, and 2.32% were stillbirths.

The data reveal substantial regional inequalities in congenital syphilis indicators across Brazil, reflecting persistent gaps in access to diagnosis and prenatal care. Strengthening public policies to expand coverage and improve prenatal care quality – especially in more vulnerable regions – is essential to prevent vertical transmission and reduce infection-related adverse outcomes.