抗梅毒治疗对妊娠结局及新生儿预后的影响

Influence of Anti-syphilis Treatment on Pregnancy Outcome and Neonatal Prognosis

目的探讨抗梅毒治疗对妊娠梅毒患者的妊娠结局及新生儿预后的影响。方法对2013年1月-12月分娩的5 224例孕妇资料进行分析。所有孕妇均经过甲苯胺红不加热血清试验(TRUST)进行筛查,筛查阳性者再进行滴度检测和梅毒螺旋体被动颗粒凝集试验(TPPA)确诊妊娠合并梅毒患者128例。根据其是否经产前检查并治疗分为治疗组(79例)和未治疗组(49例),观察并比较两组孕妇的结局及新生儿情况。结果两组孕妇妊娠结局差异较大,但差异无统计学意义(χ2=3.34,P>0.05);而两组新生儿预后情况比较则差异有统计学意义(χ2=9.14,P<0.05);且两组新生儿出生后立即取静脉血做血清学检测(TPPA和TRUST),其TPPA均为阳性,TRUST阳性85例。结论孕前、孕早期进行梅毒筛查,早期发现妊娠梅毒者进行规范的抗梅毒治疗,对降低流产、死产、胎儿畸形和新生儿先天梅毒发生率具有重要意义。

Objective To explore the influence of treatment against syphilis on pregnancy outcome and neonatal prognosis. Methods The data of 5 224 cases of pregnant women from January to December 2013 were analyzed. All the pregnant women were screened by toluidine red unheated serum test （TRUST） method. Then, T.pallidum passive partide agglutining assay （TPPA） was used to confirm those positive cases from TRUST. At last, 128 cases of syphilis in those pregnant women were confirmed. According to whether the pregnant women accepted antenatal examination and treatment, they were divided into treatment group and non-treatment group. The pregnancy outcome and neonatal prognosis of these two groups of women were then compared and analyzed. Results The pregnancy outcome of these two groups had comparatively big difference, but without significant difference （x2=3.34, P 〉 0.05）. The neonatal prognosis of the two groups was significantly different （x2=9.14, P 〈 0.05）. Moreover, TPPA showed positive in all newborn infants, and TURST showed 85 positive cases. Conclusion Early finding and treatment of pregnant women with syphilis by screening before pregnancy or during the early period of pregnancy can reduce abortion, stillbirth, fetal abnormalities, and the incidence of neonatal congenital syphilis.