深圳市妊娠梅毒及相关不良妊娠结局的疾病负担估计

Estimation on the burden of syphilis in pregnancy and associated adverse pregnancy outcomes in Shenzhen,China

目的评估深圳市2002-2012年妊娠梅毒及其相关不良妊娠结局的疾病负担的变化趋势。方法收集预防与控制梅毒母婴传播项目的监测资料,以及文献资料中的相关数据,运用妊娠梅毒及梅毒相关不良妊娠结局疾病负担估计模型进行估计。结果项目实施后,孕妇人群参加≥1次的产前保健比例、接受梅毒血清学检测的比例和妊娠梅毒患者获得足量抗梅毒治疗的比例,分别从2002年的74.86%、89.75%和84.13%上升至2012年的89.74%,97.23%和96.06%;妊娠梅毒和梅毒相关不良妊娠结局的疾病负担在2007年达到高峰,2008-2012年呈下降趋势。若未实施任何干预项目,深圳市2002-2012年间将发生4676例梅毒相关不良妊娠结局;由于项目的实施,共避免了2974例不良妊娠结局的发生。2012年全市梅毒相关不良妊娠结局发生数,与消除先天梅毒计划目标估计数相差7例。结论预防与控制梅毒母婴传播项目的实施,有效地减少了妊娠梅毒和梅毒相关不良妊娠结局的疾病负担,基本达到全球关于消除先天梅毒的目标。

Objective To estimate the trend of disease burden of syphilis in pregnancy and associated adverse pregnancy outcomes（SP-APOs）in Shenzhen from 2002 to 2012.Methods The surveillance data from syphilis prevention mother-to-child transmission（PMTCT）program and related data from published literatures were collected.The estimation model of SP-APOs disease burden was applied.Results After implementing the syphilis PMTCT program,the proportion of pregnant women with at least one antenatal care visit,the percentage of pregnant women receiving syphilis test at first antenatal care visit and the percentage of sero-positive pregnant women adequately treated for syphilis all showed increased trends.The disease burden of both syphilis in pregnancy and syphilis associated adverse outcomes（APOs）reached maximum values in the year of 2007,and displayed decreased trends from2008 to 2012.According to the estimation model,there were totally 4676 APOs cases that would occur from 2002to2012 if no intervention program was conducted among pregnant women in Shenzhen,but it currently avoided 2974 APOs due to the implementation of PMTCT program.In 2012,the distance of estimated number of APOs between Shenzhen＇s current situation and the goal of congenital syphilis elimination plan was seven cases.Conclusion The implementation of syphilis PMTCT program can effectively reduce the burden of SP-APOs,and the city of Shenzhen nearly achieves the global goal of congenital syphilis elimination.