Congenital syphilis is acquired in which of the following ways?

• A. In utero from maternal infection
• B. During delivery from contact with lesions
• C. Through breast milk
• D. Postnatally from caregivers

Answer: (A)

Congenital syphilis is transmitted to the fetus during pregnancy when Treponema pallidum crosses the placenta from an infected mother. This in utero transmission is the reason the condition is labeled congenital and why prenatal screening and timely treatment are essential to prevent fetal infection. Transmission at delivery from contact with lesions is not the typical route for establishing congenital infection, and syphilis is not transmitted through breast milk. Postnatal transmission from caregivers is not a recognized route for congenital syphilis.