福建省38418例妊娠期梅毒血清流行病学调查

Epidemiological study on 38 418 syphilis cases during pregnancy

目的探讨福建省孕产妇梅毒感染率及其危险因素。方法采用流行病学调查方法,对2004年7月1日至2006年6月30日纳入调查的对象填写调查表,在知情同意下进行快速血浆反应素环状卡片试验(RPR)筛查,凡RPR阳性者进一步检测RPR滴度,并行梅毒密螺旋体血凝试验(TPHA)以确诊,共查38418例孕产妇。确诊为感染梅毒的孕产妇共772例(其中60例未分娩).对其进行孕期干预并跟踪至产后,同时将其妊娠结局与非感染梅毒孕妇的结局进行比较。对可能影响孕妇"感染梅毒"的因素进行单因素分析和多因素logistic分析。结果孕妇梅毒感染率为1.85%(712/ 38418),绝大多数为潜伏梅毒;主要危险因素有孕妇职业、文化程度、居住地、配偶职业、经济收入、患过性病等6个因素;感染梅毒孕妇的妊娠结局比非感染梅毒孕妇妊娠结局差:如围产儿死亡率、早产率、低出生体重率均高,差异有统计学意义(P<0.01)。结论福建省妊娠期梅毒感染率逐年升高,孕妇梅毒感染对围产儿影响大;孕妇职业、文化程度、居住地、配偶职业、经济收入、患过性病等因素是福建省妊娠期梅毒感染的主要危险因素。

Objective To explore the prevalence of syphilis and risk factors on pregnant women in Fujian province. Methods From July 1^st, 2004 to June 30^th, 2006, epidemiologic methods as questionnaires to fill in and rapid plasma reagent testing （RPR） were performed. Pregnant women with positive RPR test and then were confirmed by treponema pallidum test（TP）. Intervention was provided to the pregnant women who were followed up to the postpartum periods. Results were compared during the peri-neonatal stage between syphilis-infected and non-infected women. Factors which were relative to syphilis infection were analyzed by simple and then further logistic regression analysis. Results There were 38 418 pregnant women under study, of whom 772 were confirmed including 60 who were still pregnant. The prevalence of syphilis during pregnancy was 1.85% （712/38 418）, with mostly underlying syphilis which played an important role during the neonatal stage. Main risk factors to have been found as： women＇s occupation, cultural background, place of living, husband＇s occupation, family income, having sexually transmitted disease（STD） infection. The prognosis of peri-neonatal stage was worse if the mother was having blood RPR test positive. Morality of peri-neonatal, preterm birth rate and low-birth weight rate were found also higher among mothers when RPR was positive（ P 〈 0.01）. Conclusion The prevalence of syphilis in Fujian province was going up yearly. 8 factors including women＇s occupation, cultural background, place of living, received poor health education, having multiple sexual partners, husband＇s occupation, family income and having STD were main risk factors in the province, the mother＇s status of syphilis infection would strongly relate to the peri-neonatal stage of pregnancy.