Introduction Syphilis has been recognized since the 15th century. However, despite the availability of preventive and therapeutic approaches, it continues to present a significant public health problem.

Objective To determine the prevalence, risk factors, clinical evolution and treatment of newborns at risk of congenital syphilis.

Methods Transversal study between January 2001 and December 2006, of mothers with venereal disease research laboratory (VDRL) positive titers and their newborns. We analysed sociodemografic data, prenatal care, clinical presentation, treatment and evolution of the newborn. Following our hospital’s protocol, newborns were classified in two groups according to maternal VDRL titers and treatment: group I(GI) without/incorrect treatment and/or correct treatment with stable or rising titers; group II(GII) correct treatment with decreasing titers.

Results We studied a total of 187 and 103 VDRL positive mothers and newborns, respectively. Prevalence of risk for congenital syphilis was 0.36%. Sixty-four (34%) mothers were 19–25 years old and 62% had incomplete schooling. 88% had prenatal care with 30% having stable or rising VDRL titers. Maternal risk factors were: absence of treatment (36%), Human Immunodeficiency Virus infection (10%) and drug or alcohol abuse (2.6%). Most (70%) newborns belonged to GII. Mean gestational age and weight was 38 weeks and 3150 grams, respectively. Only two were symptomatic. 95% newborns were treated with penicillin and 92% realized lumbar puncture, none being VDRL positive.

Commentary The occurrence of syphilis and the important number of VDRL positive pregnant women, indicate that the prenatal screening programs, as well as preventive measures of sexual transmitted diseases, are still not totally accomplished.