摘要
目的探究妊娠期梅毒感染对不良妊娠结局、新生儿感染情况的影响。方法收集2010年1月-2016年12月于南通市妇幼保健院进行产前检查,检测出妊娠梅毒的孕妇460例作为研究对象,逐年统计2010-2016年医院产前检查检测到的妊娠梅毒孕妇检出率;对妊娠梅毒孕妇的妊娠结局进行统计;按照孕妇的血浆反应素环状卡片实验(rapid plasma regain, RPR)首检滴度分类,将孕妇分为<1∶16和≥1∶16的两组;按照治疗程度分为正常治疗组,非正常治疗组及未治疗组,分别检测以上几组患者不良妊娠结局的发生率及胎儿先天性梅毒感染的概率。结果 2010-2016年总检测出妊娠梅毒患者460例,检出率为0.082%(460/561 039),其梅毒的发生率呈上升趋势(P<0.05);460例妊娠梅毒患者中足月活产率的新生儿328例,占71.30%;首检RPR滴度<1∶16组患者胎儿足月活产率高于首检RPR滴度≥1∶16组(P<0.05),其胎儿先天性梅毒感染率低于首检RPR滴度≥1∶16组(P<0.05);与正常治疗组相比,非正常治疗组与未治疗组胎儿的足月活产率均下降(P<0.05);与正常治疗组相比,非正常治疗组及未治疗组的不良妊娠均升高(P<0.05);与正常治疗组相比,非正常治疗组与未治疗组的胎儿患有先天性梅毒感染率均增加(P<0.05)。结论妊娠合并梅毒感染显著增加了不良妊娠结局及新生儿先天性梅毒感染率,确诊患者进行尽早正规的趋梅治疗对降低不良妊娠结局及新生儿先天性梅毒感染率具有显著的作用。
OBJECTIVE To investigate the effect of pregnancy complicated with syphilis infection on pregnancy outcome and the situation of neonatal infection. METHODS Totally 460 women who came for prenatal examinations and were detected with syphilis infection in our hospital between Jan. 2010 and Dec. 2016 were selected as subjects. Year-to-year statistics were obtained on the number and proportion of pregnant women with syphilis detected during prenatal examination from 2010 to 2016. The pregnancy outcomes of pregnant women with syphilis were analyzed. According to the titer classification of rapid plasma regain(RPR) first inspection of the pregnant women, they were divided into two groups of <1∶16 and ≥1∶16. According to the degree of treatment, they were divided into normal treatment group, non-normal treatment group and untreated group, and the incidence of adverse pregnancy outcomes in the patients of the above groups and the probability of congenital syphilis infection in the fetus were determined. RESULTS A total of 460 cases of syphilis in pregnant women were detected from 2010 to 2016, with the detection rate of 0.082%(460/561039), and the incidence of syphilis was on the rise(P<0.05). Among the 460 cases of pregnant syphilis, 328 cases of neonates were born alive at full term, accounting for 71.30%. The full-term live birth rate of the fetuses in the group with first inspection RPR titer of <1∶16 was significantly higher than that in the group with first inspection RPR titer of ≥1∶16(P<0.05), and the infection rate of congenital syphilis in the fetuses was significantly lower than that in the group with first inspection RPR titer of ≥1∶16(P<0.05). Compared with the normal treatment group, the rates of full-term fetus live births were lower(P<0.05), adverse pregnancy rates were significantly higher(P<0.05), and the fetal congenital syphilis infection rates were significantly also higher in the non-normal treatment group and untreated group(P<0.05). CONCLUSION Syphilis infection in pregnancy significantly increases the incidence of adverse pregnancy outcomes and neonatal congenital syphilis infection. Early and proper treatment of the diagnosed patients has significant effects on reducing adverse pregnancy outcomes and neonatal congenital syphilis infection rate.
作者
陈志芳
成晓燕
娄海琴
孙晓琴
刘华华
CHEN Zhi-fang;CHENG Xiao-yan;LOU Hai-qin;SUN Xiao-qin;LIU Hua-hua(Nantong City Maternal and Child Health Hospital,Nantong,Jiangsu 226018,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第16期2495-2499,共5页
Chinese Journal of Nosocomiology
基金
江苏省“333”高层次人才基金资助项目(BRA2016119)
关键词
妊娠合并梅毒
不良妊娠结局
新生儿先天性梅毒感染
Pregnancy complicated with syphilis
Adverse pregnancy outcome
Neonatal congenital syphilis infection
