2017年我国梅毒感染孕产妇梅毒治疗情况及影响因素分析

Maternal syphilis treatment and associated factors analysis in China,2017

目的探究2017年全国梅毒感染孕产妇的梅毒治疗情况及其影响因素。方法利用"中国预防艾滋病、梅毒和乙肝母婴传播管理信息系统"上报的2017年全年分娩的梅毒感染孕产妇相关信息进行单因素和多因素分析,探究孕产妇的社会人口学特征、疾病进程、实验室相关检测及诊断时期等相关因素对妊娠梅毒治疗的影响。结果本研究共纳入33070名梅毒感染孕产妇,有80.93%接受过梅毒治疗,其中孕早、中、晚期开始治疗的孕产妇分别占45.27%,28.40%和12.78%。多因素分析结果发现年龄越大、汉族、受教育程度较高、非务农、经产妇、产时或产后确诊梅毒、有既往梅毒感染史、隐性梅毒、梅毒滴度较低的孕产妇接受治疗的可能性越低。结论2017年全国梅毒感染孕产妇接受治疗的比例距"消除艾滋病、梅毒和乙肝母婴传播"目标要求的95%还有一定差距。多种因素对于梅毒感染孕产妇接受治疗均有影响。建议相关机构有针对性地为孕产妇提供梅毒筛查服务,做到早发现、早诊断、早治疗,进一步降低先天梅毒的发生。

Objective To explore the status of maternal syphilis treatment and associated factors in China.Methods Information related to demographic characteristics,syphilis infected status,laboratory testing and maternal syphilis treatment were analyzed among pregnant women infected with syphilis reported in the"China’s Information System of Prevention of Mother-to-Child Transmission of HIV,Syphilis and Hepatitis B Management"in 2017.Univariate and multivariate regression models were used to investigate the associated factors of maternal syphilis treatment.Results A total of 33070 pregnant women with syphilis infection were included in this study.80.93%had received syphilis treatment.Among those with the treatment,45.27%,28.40%and 12.78%started treatment in the early,middle and late stages of pregnancy respectively.Multivariate logistic analysis found that the pregnant women were less likely to receive syphilis treatment,who were older,Han ethnic,non-farmers,pluripara,high level of education,history of syphilis infection,latent syphilis,syphilis detected at delivery or at postpartum,lower titers of nontreponem.Conclusion In 2017,the proportion of the pregnant women with syphilis infection receiving treatment in China still fell short of 95%of the international target.Many factors have influence on the maternal syphilis treatment.It is suggested that screening services for pregnant and parturient women should be enhanced to achieve early detection,early diagnosis,early treatment,and further reduce the incidence of congenital syphilis.