2016年台州地区妊娠梅毒流行特征及新生儿结局研究

Epidemiological characteristics and neonatal outcomes of pregnant women with syphilis in Taizhou in 2016

目的:回顾性分析台州地区2016年妊娠梅毒流行特征及新生儿结局,分析本地区妊娠梅毒防治存在的问题及防治对策,降低妊娠梅毒新生儿不良结局率。方法:回顾性分析2016年台州地区共5家综合医院和3家妇产专科医院收治的182例妊娠梅毒患者的临床资料,统计患者的年龄分布、婚姻状况、职业状况、文化程度、居住地、产前体检情况、梅毒类型及分期等信息,并统计新生儿结局。根据数据分析妊娠梅毒的预防及治疗的薄弱环节,探讨对策。结果:182例妊娠梅毒患者中,年龄<25岁152人,离婚52例、无业109例、对梅毒相关认知不合格172例、小学及以下文化程度37例、外来人员58例、未行产前保健体检128例、就诊时38例有临床症状者均为2期梅毒及3期梅毒的临床症状、142例为隐性梅毒。182例妊娠梅毒患者新生儿中有110例单一或者合并多种妊娠结局不良,其中35例就诊时梅毒晚期出现心血管系统和神经系统功能障碍,行引产手术终止妊娠,38例为高危分娩,15例早产、死胎3例、畸形儿1例、胎传梅毒25例。结论:发生妊娠梅毒的患者情况复杂,卫生管理部门、防疫中心应加强妊娠梅毒相关危害的宣教,并尽可能做到对育龄女性的全覆盖,提高育龄女性预防和警惕妊娠梅毒的意识,增强积极防梅的意识,降低妊娠梅毒的发生率,提高人口素质。

Objective:To retrospectively analyze the epidemic characteristics and neonatal outcome of pregnant women with syphilis in Taizhou in 2016,in order to analyze the problems existing and countermeasures for the prevention and control of local pregnant syphilis,hereby reducing the incidence of adverse neonatal outcomes.Methods:The clinical data of 182 pregnant women with syphilis in 5 general hospitals and 3 maternity hospitals in Taizhou in 2016 was retrospectively analyzed,The age,marital status,occupation,education level,place of residence,prenatal examination,syphilis type and stage of all the patients was statistically collected and neonatal outcomes was observed.The weak links in the prevention and treatment of pregnant syphilis was analyzed and counter-measures were discussed.Results:Of the 182 pregnant women with syphilis,there were 152 ones with age<25 years old,52 cases divorced,109 cases without job,172 ones without proper understanding of syphilis,37 cases with primary school and below educational level,58 cases of migrant workers,128 cases not receiving prenatal care examination and 142 cases of latent syphilis.Of the 182 patients,there were 110 cases with at least one kind of adverse pregnancy outcomes,including 35 patients with cardiovascular system and nervous system dysfunction and adopted surgical abortion,38 cases of high-risk delivery,15 cases of premature birth,3 cases of stillbirth,a case of malformation and 25 cases of congenital syphilis.Conclusions:Health management and epidemic prevention centers should strengthen the advocacy and education against pregnancy syphilis,which ought to achieve full coverage of women of childbearing age,in order to improve the prevention and vigilance awareness against pregnant syphilis,reduce the incidence of syphilis in pregnancy and improve the quality of the population.