南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (01): 144-.

• • 上一篇    

2009~2013年妊娠合并梅毒孕妇及围产儿感染因素的调查

肖 雪,周燕媚,孙 雯,陈敦金   

  • 出版日期:2014-01-20 发布日期:2014-01-20

Prevalence of syphilis during pregnancy and risk factors for maternal and perinatal
infections: a 2009-2013 survey

  • Online:2014-01-20 Published:2014-01-20

摘要: 目的研究本地区妊娠合并梅毒的发病趋势及围产儿感染梅毒高危因素。方法对2009年1月~2013年4月本院重症孕产
妇救治中心住院的孕产妇及其妊娠合并梅毒围产儿进行多因素分析。统计指标包括孕妇年龄、孕产次、梅毒血清学结果、苄星
青霉素治疗、居住地区、配偶梅毒血清学结果、分娩方式、新生儿梅毒血清学结果(1.1.2)。结果2009~2013年我院孕产妇妊娠
合并梅毒平均发病率2.55‰,2009、2010年年发病率分别为3.08‰和3.13‰,与1994~2000年广州地区妊娠合并梅毒平均发病
率1.51‰相比显著升高(P=0.0039)。经过规范抗梅毒治疗,孕产妇的新生儿梅毒血清学检测阳性率55.81%,配偶无感染梅毒的
新生儿梅毒检测阳性率54.348%,均显著低于未治疗组(P<0.01)和配偶为梅毒患者组(P<0.05)。妊娠合并梅毒孕产妇中,配偶
系梅毒患者占82.14%,流动居民80.36%,多次孕产史78.57%。结论对本院21 920例孕产妇调查显示,近5年妊娠合并梅毒发
病率呈线性增长趋势,但是,近3年的发病率遏制在全国发病率2‰~5‰的下限。未接受抗梅毒治疗和配偶为梅毒患者系新生
儿梅毒检测阳性的高危因素;流动居民、配偶系梅毒患者和多次孕产史是孕产妇感染梅毒的高危因素。改善围产期医疗条件将
有效降低孕产妇妊娠合并梅毒发病率;建立孕产妇及配偶双方同时接受苄星青霉素治疗的医疗渠道将有效降低新生儿梅毒检
测阳性率和母婴垂直传播感染梅毒的几率。

Abstract: Objective To analyze the risk factors for maternal and perinatal syphilis infections in Guangzhou. Methods We
collected the data of pregnant women with perinatal syphilis infections from the Obstetrics Critical Care Center, Third
Affiliated Hospital of Guangzhou Medical University during the period from January, 2009 to April, 2013. Results in the 64 253
pregnant women surveyed, the mean annual incidence of syphilis during pregnancy was 2.55‰ within the surveyed period. In
women with syphilis during pregnancy, those receiving normal anti-syphilis treatment had a significantly lower rate of
neonatal serological syphilis positivity and those without treatment (55.81% vs 100%); the serological syphilis positivity rates
differed significantly between neonates with parental syphilis infection and those without (54.348% vs 20%). Of the women
with syphilis during pregnancy, 82.14% reported syphilis of the spouse, 80.36% were floating population, and 78.57% had
previous multiple pregnancies. Conclusion The incidence of syphilis during pregnancy shows a linear growth in the 5 past
years in Guangzhou. Maternal syphilis during pregnancy without proper anti-syphilis treatment and vertical transmission are
the most important risk factors for neonatal syphilis. A syphilis spouse, floating population, and multiple pregnancies all
contribute to neonatal syphilis.