海南省新生儿先天梅毒危险因素研究

Risk factors of congenital syphilis in newborns in Hainan

目的研究海南省新生儿先天性梅毒的危险因素,为进一步预防与控制梅毒母婴传播提供科学数据。方法对发生先天梅毒的新生儿进行巢式病例对照研究,随访调查海南省2007—2014年期间符合本研究纳入标准的新生儿,将发生先天梅毒的新生儿作为病例组,将健康生育的新生儿作为对照组,分析探索新生儿先天梅毒的危险因素。结果随访期间共发生53例新生儿先天性梅毒,单因素logistic回归分析表明孕妇血清TRURST滴度(OR=2.04,90%CI:1.73～2.42)和分娩前未驱梅治疗(OR=1.82,90%CI:1.09～2.42)以及分娩前治疗药物是普鲁卡因青霉素(OR=2.54,90%CI:,1.11～5.82)是新生儿先天性梅毒发病的危险因素。进一步多因素logistic回归分析表明孕妇血清TRURST滴度每升高一个滴度,新生儿先天性梅毒发病风险增加1.23倍;分娩前未治疗孕妇梅毒较已治疗孕妇的新生儿先天性梅毒发病风险高1.09倍。结论新生儿先天性梅毒的危险因素有孕妇血清TRUST高滴度,以及分娩前孕妇梅毒未进行治疗,应加大对这两方面的干预,以期达到控制梅毒垂直传播的目的。

Objective To investigate the risk factors of congenital syphilis in newborns in Hainan Province, so as toprovide the data for further prevention and control of maternal-neonatal transmission of syphilis. Methods A nested case-control study was designed for this research. From 2007 to 2014, the newborns who met the inclusion criteria were followed up.The subjects were divided into a case group and a control group. The newborns with congenital syphilis were viewed as the casegroup. The newborns in the control group were healthy. Results During the follow-up, 53 cases of congenital syphilisoccurred. Univariate logistic regression analysis showed that the risk factors of congenital syphilis in newborns were pregnancyserum TRURST titer（OR=2.04, 90%CI：1.73～2.42）, no syphilis treatment for pregnant women before delivery（OR=1.82,90%CI：1.09～2.42）, and procaine penicillin（OR=2.54,90% CI：1.11～5.82） is the treatment drug before delivery. Furthermultivariate logistic regression analysis showed： while the pregnancy serum TRUST titer rose one titer, the risk of congenitalsyphilis increased by 1.23 times. If the women with syphilis never received the syphilis treatment before delivery, the risk ofcongenital syphilis increased by 1.09 times compared with that in the women with syphilis who received the syphilis treatmentbefore delivery. Conclusion The risk factors of congenital syphilis in newborns include the high pregnancy serum TRUSTtiter and the women with syphilis who never receive the syphilis treatment.