CAJ | 학술논문

目的：研究本地区妊娠合并梅毒的发病趋势及围产儿感染梅毒高危因素。方法对2009年1月~2013年4月本院重症孕产妇救治中心住院的孕产妇及其妊娠合并梅毒围产儿进行多因素分析。统计指标包括孕妇年龄、孕产次、梅毒血清学结果、苄星青霉素治疗、居住地区、配偶梅毒血清学结果、分娩方式、新生儿梅毒血清学结果（1.1.2）。结果2009~2013年我院孕产妇妊娠合并梅毒平均发病率2.55‰，2009、2010年年发病率分别为3.08‰和3.13‰，与1994~2000年广州地区妊娠合并梅毒平均发病率1.51‰相比显著升高（P=0.0039）。经过规范抗梅毒治疗，孕产妇的新生儿梅毒血清学检测阳性率55.81%，配偶无感染梅毒的新生儿梅毒检测阳性率54.348%，均显著低于未治疗组（P<0.01）和配偶为梅毒患者组（P<0.05）。妊娠合并梅毒孕产妇中，配偶系梅毒患者占82.14%，流动居民80.36%，多次孕产史78.57%。结论对本院21920例孕产妇调查显示，近5年妊娠合并梅毒发病率呈线性增长趋势，但是，近3年的发病率遏制在全国发病率2‰~5‰的下限。未接受抗梅毒治疗和配偶为梅毒患者系新生儿梅毒检测阳性的高危因素；流动居民、配偶系梅毒患者和多次孕产史是孕产妇感染梅毒的高危因素。改善围产期医疗条件将有效降低孕产妇妊娠合并梅毒发病率；建立孕产妇及配偶双方同时接受苄星青霉素治疗的医疗渠道将有效降低新生儿梅毒检测阳性率和母婴垂直传播感染梅毒的几率。
목적：연구본지구임신합병매독적발병추세급위산인감염매독고위인소。방법대2009년1월~2013년4월본원중증잉산부구치중심주원적잉산부급기임신합병매독위산인진행다인소분석。통계지표포괄잉부년령、잉산차、매독혈청학결과、변성청매소치료、거주지구、배우매독혈청학결과、분면방식、신생인매독혈청학결과（1.1.2）。결과2009~2013년아원잉산부임신합병매독평균발병솔2.55‰，2009、2010년년발병솔분별위3.08‰화3.13‰，여1994~2000년엄주지구임신합병매독평균발병솔1.51‰상비현저승고（P=0.0039）。경과규범항매독치료，잉산부적신생인매독혈청학검측양성솔55.81%，배우무감염매독적신생인매독검측양성솔54.348%，균현저저우미치료조（P<0.01）화배우위매독환자조（P<0.05）。임신합병매독잉산부중，배우계매독환자점82.14%，류동거민80.36%，다차잉산사78.57%。결론대본원21920례잉산부조사현시，근5년임신합병매독발병솔정선성증장추세，단시，근3년적발병솔알제재전국발병솔2‰~5‰적하한。미접수항매독치료화배우위매독환자계신생인매독검측양성적고위인소；류동거민、배우계매독환자화다차잉산사시잉산부감염매독적고위인소。개선위산기의료조건장유효강저잉산부임신합병매독발병솔；건립잉산부급배우쌍방동시접수변성청매소치료적의료거도장유효강저신생인매독검측양성솔화모영수직전파감염매독적궤솔。
Objective To analyze the risk factors for maternal and perinatal syphilis infections in Guangzhou. Methods We collected the data of pregnant women with perinatal syphilis infections from the Obstetrics Critical Care Center, Third Affiliated Hospital of Guangzhou Medical University during the period from January, 2009 to April, 2013. Results in the 64 253 pregnant women surveyed, the mean annual incidence of syphilis during pregnancy was 2.55‰within the surveyed period. In women with syphilis during pregnancy, those receiving normal anti-syphilis treatment had a significantly lower rate of neonatal serological syphilis positivity and those without treatment (55.81%vs 100%);the serological syphilis positivity rates differed significantly between neonates with parental syphilis infection and those without (54.348% vs 20%). Of the women with syphilis during pregnancy, 82.14% reported syphilis of the spouse, 80.36% were floating population, and 78.57% had previous multiple pregnancies. Conclusion The incidence of syphilis during pregnancy shows a linear growth in the 5 past years in Guangzhou. Maternal syphilis during pregnancy without proper anti-syphilis treatment and vertical transmission are the most important risk factors for neonatal syphilis. A syphilis spouse, floating population, and multiple pregnancies all contribute to neonatal syphilis.