江苏省2013—2016年梅毒感染孕产妇的流行特征及不良妊娠结局

Epidemiological characteristics and adverse pregnancy outcomes of maternal syphilis in Jiangsu province,2013-2016

目的了解江苏省梅毒感染孕产妇的流行病学特征及不良妊娠结局发生情况,并分析不良妊娠结局的相关影响因素。方法数据来源于国家预防母婴传播管理信息系统,对系统内登记的江苏省2013—2016年间分娩的梅毒感染孕产妇进行分析。结果2013—2016年江苏省共有5462例梅毒感染孕产妇分娩,平均年龄为(27.28±5.37)岁,88.46%的感染孕产妇在孕37周前接受初次产前保健,然而37.53%的感染者在37周后才开始接受治疗或未治疗。655例(12.0%)梅毒感染孕产妇发生不良妊娠结局,其中包括死胎/早期新生儿死亡、早产/低出生体重和新生儿先天梅毒。感染孕产妇非梅毒螺旋体抗体高滴度、初次治疗时间迟于28周与发生不良妊娠结局风险增加相关,调整比值比(aOR)值分别为3.19[95%可信区间(CI):1.92~5.30]和5.30(95%CI:3.99~7.06)。结论江苏省梅毒感染孕产妇的不良妊娠结局负担较高,仍需加强综合干预措施落实,以提高对孕产妇梅毒的筛查和治疗。

Objective To investigate the epidemiological characteristics and adverse pregnancy outcomes of the women infected with syphilis in Jiangsu province.Methods Data were collected from the national information system of prevention of mother-to-child transmission of syphilis.Women registered in the system and delivered during2013-2016 were included in the analysis.Results A total of 5462 pregnant women infected with syphilis delivered in Jiangsu during 2013-2016.Their average age was 27.28±5.37 years old.88.46%received antenatal care at or before 37 gestational weeks.However,37.5% received no treatment or initiated the treatment after 37 gestational weeks.12.0%of them suffered serious adverse pregnancy outcomes including stillbirth/neonatal death,preterm delivery/low birth weight,or congenital syphilis in newborns.High maternal titer and late treatment(>28 gestational weeks)/non-treatment were significantly associated with increased risks of adverse pregnancy outcomes and the adjusted ORs were 3.19(95%CI:1.92-5.30)and 5.30(95%CI:3.99-7.06).Conclusion Burden of adverse pregnancy outcomes is high among syphilis infected women in Jiangsu.Comprehensive interventions need to be strengthened to improve uptake of screening and treatment for maternal syphilis.