Evaluation of leukocytes and inflammatory profile in newborns with
congenital syphilis.
Newborn; Congenital Syphilis; Syphilis Exposure; Neurosyphilis; Inflammation.
Syphilis, caused by the bacterium Treponema pallidum, is one of the oldest described sexually transmitted infections and has a global distribution. Gestational syphilis remains an important public health problem, being associated with adverse neonatal outcomes and the occurrence of congenital syphilis. This study aimed to evaluate maternal and neonatal clinical characteristics, as well as immunological aspects associated with exposure to and congenital infection by T. pallidum. The research was conducted at the Maternity School Januário Cicco of UFRN. After obtaining TCLE, 27 pregnant women and 28 newborns were included and distributed into four groups: control (n = 10), exposed syphilis without congenital infection (SE, n = 10), congenital syphilis (SC, n = 6), and neurosyphilis (NS, n = 2). Medical record analysis and whole blood collection were performed for hematological and leukocyte evaluation, as well as serum collection for immunodiagnosis (VDRL) and quantification of biochemical markers, cytokines, and chemokines by CBA. The mean maternal age ranged from 25.5 ± 7.87 years (SC) to 31.5 ± 6.36 years (NS), with no statistically significant difference between groups (p = 0.3647). Socioeconomic analysis indicated greater social vulnerability in the groups associated with syphilis, especially congenital syphilis and neurosyphilis, evidenced by lower educational levels and higher unemployment rates. Chronic arterial hypertension was the most frequent maternal comorbidity. Clinically, no differences were observed between groups regarding anthropometric parameters at birth, with a predominance of newborns appropriate for gestational age and mostly normal radiological evaluation of long bones, although newborns in the SE and SC groups presented lower mean birth weights and a higher frequency of infants classified as small for gestational age. In the hematological analysis, a reduction in red blood cell count was observed in newborns from the SC group, without significant changes in other parameters. In the immunological analysis, newborns with congenital syphilis showed increased levels of IL-2, IL-12p70, IL-4, IL-1β, and IL-10 compared to the control group, whereas IFN-γ, TNF-α, IL-5, and IL-17, as well as the chemokines CCL2, CXCL8, CXCL9, and CXCL10, did not show significant differences between groups. These findings suggest that, even in the absence of evident clinical alterations at birth, congenital syphilis is associated with a distinct pattern of immune activation in the first days of life, reinforcing the potential of neonatal immunological assessment as a complementary approach to understanding the pathophysiology of the disease.