妊娠梅毒母婴传播干预后先天梅毒发病情况分析

Analysis of incidence of congenital syphilis after intervention for syphilis mother-to-child transmission among pregnant women

目的了解深圳市启动预防与控制梅毒母婴传播项目后,先天梅毒的发病情况,为先天梅毒的预防、诊断、治疗及随访管理提供参考依据。方法对宝安区妇幼保健院建档的疑似先天梅毒患儿的发病情况进行分析,对孕妇开展血清学筛查及确诊,根据19S-IgM-梅毒螺旋体明胶凝集试验(19S-IgM-TPPA)确诊先天梅毒,对疑似先天梅毒病例,根据随访结果进一步明确诊断。结果 2004-2009年共检测孕妇67 693例,孕妇梅毒阳性率0.59%;在310例疑似先天梅毒患儿中共确诊79例,发病率从2004年的431例/10万活产儿下降至2009年的127例/10万活产儿。结论 6年间孕妇梅毒的阳性率及先天梅毒的发病率均显著性下降。

Objective To explore the incidence of congenital syphilis since a project to prevent and control syphilis mother-to-child transmission was initiated in Shenzhen so as to provide evidence for prevention,diagnosis,treatment and following-up of congenital syphilis.Methods The symptoms and signs of 310 children with suspected congenital syphilis were analyzed,and serological screening was conducted among pregnant women in Bao＇an Maternity and Chlid Health Hospital in Shenzhen from January of 2004 to December of 2009.Congenital syphilis was diagnosed with TRUST and TPPA assays;and suspected cases of congenital syphilis were confirmed by 19S-IgM-TPPA.Results From 2004 to 2009,67 693 pregnant women were screened by TRUST and TPPA.In this cohort,0.59% were positive for syphilis.Seven-nine children were diagnosed as congenital syphilis among the 310 suspected cases.The prevalence of congenital syphilis shifted from 431 cases per 100000 live birth to 127 cases per 100000 live birth.Both the positive rate of syphilis in pregnant women and the prevalence of congenital syphilis were significantly decreased.Conclusion The incidence of congenital syphilis was decreased year by year in Bao＇an district,since Shenzhen started a project for prevention and control of syphilis mother-to-child transmission.