2013-2015年上海市浦东新区梅毒母婴阻断服务利用的影响因素分析

Analysis on the influencing factors of syphilis mother-to-child transmission blocking service utilization in Shanghai Pudong New District from 2013 to 2015

目的了解浦东新区影响梅毒母婴阻断服务利用的相关因素,为进一步改进服务的方向和措施提供参考。方法对2013年1月-2015年12月浦东新区上报的妊娠梅毒孕产妇个案及围生儿信息进行分析。统计指标包括孕妇年龄等人口学因素、是否治疗、筛查及确诊治疗的孕周等。结果 2013-2015年浦东新区检出妊娠梅毒孕妇共380例,有完整分娩结局的315例。经多因素分析后,就诊于综合性医院的患者确诊治疗孕周晚于妇幼专科医院,OR值为2.410、95%CI为1.398~4.156;患者接受至少一个疗程治疗的比例低于妇幼专科医院,OR值为1.944、95%CI为1.174~3.219。结论如何优化服务、促进妊娠梅毒孕产妇早筛查、早诊断、早治疗是母婴阻断服务成功的关键。

Objective To investigate the relevant influencing factors of syphilis mother-to-child transmission blocking service utilization in Shanghai Pudong New District,provide a reference for further improving servide orientation and measures. Methods The records of pregnant women with syphilis and information of perinatal infants reported by Shanghai Pudong New District from January 2013 to December2015 were analyzed,the statistical indexes included demographic factors(such as maternal age）,treatment,screening,and gestational week of definite diagnosis. Results From 2013 to 2015,380 pregnant women were found with syphilis in Shanghai Pudong New District,and 315 pregnant women of them had intact delivery outcomes. Multivariate analysis showed that the gestational week of definite diagnosis in the patients from comprehensive hospitals was later than that in the patients from maternal and child specialist hospitals(OR = 2. 410,95%CI： 1. 398-4. 156）,and the proportion of receiving at least one course of treatment in the patients from comprehensive hospitals was lower than that in the patients from maternal and child specialist hospitals(OR = 1. 944,95% CI： 1. 174-3. 219）. Conclusion Optimizing service,promoting early screening,early diagnosis,and early treatment are key points to block mother-to-child transmission of syphilis successfully.