Objective: To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. Method: This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. Results: A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). Conclusion: Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.
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