Background:
Congenital syphilis is still one of the most devastating preventable outcomes of syphilis. Fetal complications include spontaneous abortions and stillbirths, and infant complications include system disorders and death. Treatment of maternal syphilis with penicillin is highly effective in preventing CS.

Objective:
Describe the trends of incidence rate of congenital syphilis, demographic and socioeconomic characteristics of the mothers with congenital syphilis cases for the period 2000-2006 in Puerto Rico.

Method:
Data from the US Census Bureau and Puerto Rico STD Surveillance Office was used to describe the demographic characteristics, risk factors and to calculate the incidence rate of CS in Puerto Rico from 2000-2006.

Result:
For mothers of congenital syphilis cases, period 2000-2006:
- There was an average of 17 cases per year.
- Ages 25-29 years old, generally have the highest number of congenital cases (33.1%).
- 89.3% received inadequate or no prenatal care (≤ 12 medical visits).
- 58.8% received inadequate syphilis treatment.
- 72% reported being single never married.
- 81.4% reported having the Health Care Reform Insurance (based managed care) for medical insurance coverage.

Conclusion:
Improve the knowledge on STD prevention, diagnosis and treatment is urgent for both patients and health care providers. Most of the cases of CS correspond to women in reproductive age, single and with Health Care Reform Insurance coverage.

Implications:
Persistence of Congenital Syphilis cases is a poor public health status indicator. An adequate and timely treatment can lead to costs reduction in medical expenses related to mothers and infants' health. Education and counseling to women at risk can also improve infants' health and prevent death.