综合干预妊娠合并梅毒的调查研究

Investigation research on comprehensive intervention of pregnancy complicating with syphilis

目的探讨嘉兴市预防梅毒母婴传播的干预措施及干预效果。方法回顾性分析2012年6月到2013年12月嘉兴市妊娠合并梅毒感染的孕产妇治疗情况及妊娠结局。结果梅毒感染孕产妇270例,年龄最大42岁,最小18岁,平均年龄26.62±5.24岁。其中分娩178人,活产173例,死胎5例;自然流产3例,人工终止妊娠18例。不同干预措施下新生儿异常情况(早产或低出生体重、出生缺陷等)发生率存在显著差异(χ2=12.924,P<0.01)。儿童满6月龄且感染状态明确的75例,其中排除感染60例,确诊先天梅毒15例,14例出生时即确诊,1例为随访过程中RPR滴度不下降反而上升。不同干预措施下儿童感染状态差异有统计学意义(χ2=6.348,P<0.05)。结论规范干预可以有效改善梅毒孕产妇不良妊娠结局并促进儿童健康。

Objective To explore the intervention measures and effect of prevention of mother to child transmission of syphilis in Jiaxing City. Methods Retrospective analysis was conducted on maternal treatment and pregnancy outcomes of pregnant women with syphilis infection in Jiaxing City from June 2012 to December 2013. Results Syphilis infection was found in 270 cases. The oldest case was 42 years old and the youngest was 18 years old,with the average age of 26. 62 ± 5. 24 years old. There were 178 cases giving birth,including173 cases of live births and 5 cases of stillbirth. There were 3 cases of spontaneous abortion and artificial termination of pregnancy was performed in 18 cases. By different intervention measures the incidence of neonatal abnormalities（ preterm birth or low birth weight,birth defects） was significantly different（ χ2= 12. 924,P〈0. 01）. Totally 75 cases of 6-month-old infants were diagnosed with clear infection,among whom 60 cases were excluded and 15 cases were confirmed with congenital syphilis. Fourteen of them were diagnosed at birth and 1case was found with increased RPR titer during follow-up. The infection status of infants was statistically significant when intervention measures provided were different（ χ2= 6. 348,P〈0. 05）. Conclusion Normative intervention can effectively improve the pregnancy outcomes of pregnant women with syphilis and promote infant＇s health.