妊娠合并梅毒感染者发生不良妊娠结局的临床调查研究

Adverse pregnancy outcomes investigation of pregnant women with syphilis infection

目的:分析妊娠合并梅毒感染孕妇发生不良妊娠结局的影响因素,为妊娠合并梅毒感染孕妇临床治疗方案选择提供参考。方法:回顾性分析2009年2月至2012年8月四川省交通运输厅公路医院产科收治204例及2012年8月至2015年10月成都市西区医院产科收治120例妊娠合并梅毒患者,统计孕妇出现不良妊娠结局的情况,比较不良妊娠结局和正常妊娠结局两组患者临床资料的差异,分析妊娠合并梅毒患者发生妊娠不良结局的影响因素,将对不良妊娠结局有影响的因素再采用Logistic多因素回归分析,分析妊娠合并梅毒感染者发生不良妊娠结局的危险因素,针对危险因素探讨预防妊娠合并梅毒感染者发生不良妊娠结局的措施。结果:324例妊娠合并梅毒感染患者中有24例(7.41%)出现不良妊娠结局,对正常组300例患者和不良结局组24例患者的临床资料分析,结果显示,产次、年龄、就诊时梅毒分期、其它传染病、驱梅疗程、随访执行情况是影响妊娠合并梅毒感染患者妊娠结局的相关因素;经Logistic多因素回归分析,就诊时梅毒为中晚期、有其他传染病、完成驱梅疗程≤1、未严格执行随访计划是妊娠合并梅毒感染患者妊娠结局不良的危险因素。结论:妊娠合并梅毒感染患者的不良妊娠结局发病率较高,影响妊娠合并梅毒感染不良妊娠结局的因素较多,在加强对孕妇进行梅毒筛查的同时,应加强梅毒感染孕妇的后续治疗和管理,确保梅毒感染得到有效控制,降低梅毒感染对妊娠结局的不良影响,提高孕妇的妊娠预后。

Objectives： To analyze the factors that influence adverse pregnancy outcomes of pregnant women complicated with syphilis so as to provide reference for clinical treatment of pregnant women with syphilis. Methods：A retrospective analysis was done on 324 syphilis- infected pregnant women in our hospital from February 2009 to October 2015. Differences in the clinical data between patients with adverse pregnancy outcomes and patients with normal pregnancy outcomes were analyzed as well as influential factors of adverse pregnancy outcomes. Logistic multivariate regression analysis was taken to analyze risk factors for pregnant women with syphilis infection so as to explore prevention measures of adverse pregnancy outcomes for pregnant women with syphilis infection. Results： Among the 324 pregnancy women complicated with syphilis,there were 24（ 7. 41%） cases with adverse outcomes. Analysis on clinical outcome data of these patients showed that parity,age,syphilis stage,other infectious diseases,antisyphilitic treatment and patient compliance were the relevant factors affecting pregnancy outcome. According to multivariate logistic regression analysis,late treatment stageof syphilis,other infectious diseases,antisyphilitic course ≤1 weeks and bad patient compliance were risk factors. Conclusion： Syphilis- infected pregnancy has higher incidence of adverse pregnancy outcomes. There are many factors affecting the pregnancy outcomes of pregnancy complicated with syphilis.Physicians should strengthen syphilis screening and treatment for pregnant women,and strengthen the follow- up treatment and management of syphilis infection in pregnant women to ensure effective control of syphilis infection,reduce adverse effects on pregnancy outcomes and improve pregnancy outcome in pregnant women.