The laboratory diagnosis of congenital syphilis: a review.

The serodiagnosis of congenital syphilis is reviewed. Maternal history is the least reliable criterion for detecting congenital syphilis. A positive maternal history may or may not be valid; a negative maternal history does not rule out the possibility of congenital syphilis. Syphilis serology performed on the infant is a better criterion for detecting asymptomatic congenital syphilis or delayed onset. Serial VDRL titers on the infants are the best diagnostic tool presently available. A decreasing titer indicates the presence of maternally derived antibodies. The FTA-ABS (IgM) is still not sufficiently evaluated and standardized for routine clinical application.