Neurological Assessment Scales in Hospitalized Newborns with Congenital Syphilis

Background: Congenital syphilis (CS) is a transplacental infection that an lead to many long-term sequelae when not adequately treated; however, knowledge about the motor and neurological signs that newborns (NB) with CS may present is scarce. Objective: To describe the results of neurological assessment scales and general movements in NB with CS in the first days of life. Methods: Cross-sectional study. The Hammersmith Neonatal Neurological Examination (HNNE) and General Movements Assessment (GMA) scales were used to evaluate NB under treatment for CS in a public Brazilian hospital in the first days of life. Results: Sample consisted of 11 NB, with a mean birth weight of 3140.5g, and Apgar score at 5 minutes of 8.3. Among the 11 mothers, 4 (36.4%) had fewer than 6 prenatal visits and 5 (45.5%) did not receive any syphilis treatment. All NB (100%) were asymptomatic, with normal long bone X-rays and cerebrospinal fluid analysis. The mean score on the HNNE was 22 (suboptimal/abnormal). Eight NB (72.7%) showed abnormalities on GMA scale (6 [54.5%] being mildly abnormal and 2 [18%] definitely abnormal. Only 3 NB (27.3%) returned for outpatient follow-up. Conclusions: A high prevalence of abnormalities in neurological and GMA scales was observed in NB with asymptomatic CS in the first days of life. Most mothers did not receive adequate treatment for syphilis during pregnancy, and there were important deficiencies in post-discharge follow-up. Further studies are needed to confirm these findings and investigate whether the observed abnormalities are linked to biological or environmental factors during pregnancy. Keywords: Congenital syphilis; newborns; neurological examination.