天长市2016—2021年梅毒感染孕产妇妊娠结局及影响因素调查

Survey on pregnancy outcome and influencing factors of pregnant women infected with syphilis in Tianchang City from 2016 to 2021

目的 了解梅毒感染孕产妇不良妊娠结局检出率及影响因素。方法 以2016—2021年在天长市预防艾滋病、梅毒和乙型肝炎母婴传播管理信息系统报告的梅毒感染孕产妇为病例组,按1∶2比例选择同期匹配年龄、文化程度、居住地、相同年度的非梅毒孕产妇作为对照组,对病例组孕产妇进行动员治疗、干预并随访,收集对照组孕产妇相关信息,观察两组妊娠结局,并比较不良妊娠结局检出率。将病例组孕产妇按照年龄、婚姻状况、发现时孕周、血清学滴度、治疗情况进行分组,分析不良妊娠结局的影响因素。结果 2016—2021年天长市共对33 315名孕产妇进行梅毒检测,孕产妇梅毒检出率为0.48%。妊娠合并梅毒者不良妊娠检出率11.25%,高于非梅毒孕产妇的5.94%(χ^(2)=4.148,P=0.042)。单因素及多因素分析显示,梅毒孕产妇发生不良妊娠结局的危险因素为非婚状态(OR=4.611,95%CI:1.194~17.809)和不规范治疗(OR=6.768,95%CI:2.044~22.858)。结论 天长市梅毒感染孕产妇不良妊娠结局检出率高于非梅毒感染孕产妇,梅毒孕产妇非婚状态和不规范治疗为不良妊娠结局的独立危险因素。

Objective To understand the incidence and influencing factors of adverse pregnancy outcomes in pregnant women infected with syphilis.Methods The pregnant women infected with syphilis reported in Tianchang Maternal and Infant Transmission Management Information System for Prevention of AIDS,Syphilis and Hepatitis B from 2016 to 2021 were taken as the case group,and the matched age,education level,residence and non syphilis pregnant women in the same year were selected as the control group in a ratio of 1 ∶ 2.The pregnant women in the case group were mobilized for treatment,intervention and follow-up,and the relevant information of pregnant women in the control group was collected.The pregnancy outcomes of the two groups were observed,and the incidence of adverse pregnancy outcomes was compared.The pregnant women in the case group were grouped according to age,marital status,gestational week at the time of discovery,serological titers,and treatment status,and the influencing factors of adverse pregnancy outcomes were analyzed.Results A total of 33 315 pregnant women were tested for syphilis in Tianchang City from 2016-2021,the maternal syphilis detection rate was 0.48%.The incidence of adverse pregnancy in pregnant women infected with syphilis was 11.25%,higher than 5.94% in non syphilitic pregnant women(χ^(2) = 4.148,P= 0.042).Univariate and multivariate analysis showed that the risk factors for adverse pregnancy outcomes in syphilis pregnant women were unmarried status(OR= 4.611,95%CI:1.194-17.809) and non-standard treatment(OR= 6.768,95%CI:2.044-22.858).Conclusion The incidence of adverse pregnancy outcomes among syphilis infected pregnant women in Tianchang City is higher than that of non syphilis infected pregnant women.Non marital status and non-standard treatment of syphilis pregnant women are independent risk factors for adverse pregnancy outcomes.