CD40LG and Cowden syndrome 1: The DPP Syphilis TnT RUO POC assay's treponemal IgM levels discriminated CS risk categories effectively and may supplement current algorithms to improve neonatal CS stratification.IMPORTANCECongenital syphilis (CS) continues to rise in the United States and globally, yet diagnosis at birth remains difficult because no single laboratory test definitively confirms infection in newborns.