Titers declined after treatment along typical patterns: Titers in patients with primary and secondary disease fell more rapidly than in those with later-stage disease, and older age predicted relatively slow titer response. Although only 63 of the women (38%) achieved fourfold decreases in titer by delivery, the 27 cases of congenital syphilis identified were divided equally between neonates of faster and slower responders. None of the women required retreatment for presumed treatment failure.