98例孕产妇合并梅毒妊娠结局相关因素分析
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摘要
目的为了解本地区孕产妇梅毒感染情况,做到早发现、早治疗,及时阻断传染病在母婴之间的传播。方法 2014年1月~2015年5月所有对象的血清标本进行梅毒螺旋体抗体检测,并将结果应用统计学方法分析梅毒筛查率和确诊率,确诊的妊娠期合并梅毒感染患者98例,根据治疗与否将其分为治疗组和对照组,人数分别为27例和71例、分娩时的TRUST滴度(是否<1∶4)人数为76例和22例、初次筛查时的孕周(是否大于24周)人数为65例和22例,分析梅毒孕产妇的妊娠结局及先天梅毒儿发生率,并对不良妊娠结果相关影响因素进行分析。结果 2014年1月~2015年5月梅毒感染孕产妇为98例,规范治疗率9.18%(9/98),先天梅毒儿8例,治疗组:不良妊娠结局发生率为7.14%(2/28),先天梅毒儿发生率为3.6%(1/28);初检孕周<24周的不良妊娠结局发生率为44.61%(29/65),先天梅毒儿发生率为4.61%(3/65),≥24周不良妊娠结局为52.17%(12/23),先天梅毒21.73%(5/23),两组不良妊娠结局和先天梅毒儿发生率比较,差异有统计学意义(P<0.05);TRUST滴度<1∶4组的不良妊娠发生率为5.97%(39/76),先天梅毒儿1.31%(1/76)TRUST滴度≥1∶4组的不良妊娠发生率为54.17%(12/22),先天梅毒儿31.81(7/22)两组差异有统计学意义(P<0.05)。结论对于妊娠合并梅毒患者应开展孕早期梅毒筛查工作,及时进行规范的抗病毒治疗,可降低不良妊娠发生率和先天梅毒儿的发病率。孕妇血清TRUST滴度是影响妊娠结局的重要因素。
Objective To understand the situation of maternal syphilis infection in the area,to achieve early detection,early treatment, timely blocking the spread of infectious diseases in the mother and infant. Methods Test result of serum specimens for syphilis helicoid antibody detection from 2014 January to 2015 May were applied with statistical methods to analyze syphilis screening rate and diagnosis rate,the diagnosis of pregnancy complicated with syphilis infection in 98 cases.According to the treatment,pregnant were divided into two group-treatment group and control group,the number of people were 27 cases and 71 cases.Childbirth Trust titer(whether < 1 ∶ 4) number were 76 cases and 22 cases,initial screening of gestational weeks(if more than 24 weeks) number were 65 cases and 22 cases.To analyzed syphilis maternal outcome of pregnancy and congenital syphilis incidence and of adverse outcome of pregnancy related factors. Results There were 98 cases of syphilis infection in pregnant women from 2014 January to 2015 May, standardized treatment rate was 9.18%(9/98),the congenital syphilis were 8 cases.Treatment group:the incidence of adverse pregnancy outcomes was 7.14%(2/28),congenital syphilis incidence was%(1/28);early detection of gestational age < 24 weeks the incidence of adverse pregnancy outcomes was 44.61%(29/65),congenital syphilis incidence rate was 4.61%(3/65),more than 24 weeks of adverse pregnancy outcomes was 52.17%(12/23),congenital syphilis rate was 21.73%(5/23),two groups of adverse pregnancy outcomes and congenital syphilis were compared,the difference was statistically significant(P < 0.05);TRUST was less than 1 ∶ 4 groups of adverse pregnancy rate was 5.97%(39/76),congenital syphilis in 1.31%(1/76) TRUST titer is greater than or equal to 1 ∶ 4 groups of adverse pregnancy rate was 54.17%(12/22),congenital syphilis in 31.81(7/22)had statistical difference between the two groups Significance of learning(P < 0.05). Conclusion For pregnant women with syphilis should carry out the work of early syphilis screening, timely standardized antiviral treatment, can reduce the incidence of adverse pregnancy and congenital syphilis incidence rate.The serum TRUST titer of pregnant women is an important factor that affects the pregnancy outcome.
Objective To understand the situation of maternal syphilis infection in the area,to achieve early detection,early treatment, timely blocking the spread of infectious diseases in the mother and infant. Methods Test result of serum specimens for syphilis helicoid antibody detection from 2014 January to 2015 May were applied with statistical methods to analyze syphilis screening rate and diagnosis rate,the diagnosis of pregnancy complicated with syphilis infection in 98 cases.According to the treatment,pregnant were divided into two group-treatment group and control group,the number of people were 27 cases and 71 cases.Childbirth Trust titer(whether < 1 ∶ 4) number were 76 cases and 22 cases,initial screening of gestational weeks(if more than 24 weeks) number were 65 cases and 22 cases.To analyzed syphilis maternal outcome of pregnancy and congenital syphilis incidence and of adverse outcome of pregnancy related factors. Results There were 98 cases of syphilis infection in pregnant women from 2014 January to 2015 May, standardized treatment rate was 9.18%(9/98),the congenital syphilis were 8 cases.Treatment group:the incidence of adverse pregnancy outcomes was 7.14%(2/28),congenital syphilis incidence was%(1/28);early detection of gestational age < 24 weeks the incidence of adverse pregnancy outcomes was 44.61%(29/65),congenital syphilis incidence rate was 4.61%(3/65),more than 24 weeks of adverse pregnancy outcomes was 52.17%(12/23),congenital syphilis rate was 21.73%(5/23),two groups of adverse pregnancy outcomes and congenital syphilis were compared,the difference was statistically significant(P < 0.05);TRUST was less than 1 ∶ 4 groups of adverse pregnancy rate was 5.97%(39/76),congenital syphilis in 1.31%(1/76) TRUST titer is greater than or equal to 1 ∶ 4 groups of adverse pregnancy rate was 54.17%(12/22),congenital syphilis in 31.81(7/22)had statistical difference between the two groups Significance of learning(P < 0.05). Conclusion For pregnant women with syphilis should carry out the work of early syphilis screening, timely standardized antiviral treatment, can reduce the incidence of adverse pregnancy and congenital syphilis incidence rate.The serum TRUST titer of pregnant women is an important factor that affects the pregnancy outcome.
引文
[1]王芳,杜秉新,周新华,等.松江区妇女妊娠合并梅毒的现况观察[J].中国妇幼保健,2009,24(12):1670-1672.
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[6]付翰林,刘晓英,秦家碧,等.我国妊娠梅毒中先天梅毒报告发病率的Meta分析[J].中华传染病杂志,2015,33(6):363-368.
[7]2011~2014年河南省孕产妇感染率[J].中华疾病控制杂志,2015,19(8):849-850,859.
[8]周红.婚前医学检查传染病筛查分析[J].中外健康文摘,2013,10(38):134-135.
[9]李焱冰.从疾病检出率看婚检的必要性[J].医学信息,2015,28(43):346.
[10]熊庆,吴康敏.有关传染病的婚育医学意见[J].妇女保健学,2007,9:92-95.
[11]熊庆,吴康敏.妊娠合并性传播疾病对母儿的影响[J].妇女保健学,2007,9:140-141.
[12]林松,全钰平.妊娠梅毒与先天梅毒[J].中国妇幼健康研究,2013,4:618-620.
[13]邱琇,王临虹.妊娠梅毒对HIV母婴传播的影响[J].中国艾滋病性病,2008,14(3):308-310.
[14]陈璇,驱梅.治疗时机对妊娠合并梅毒孕妇妊娠结局的影响[J].贵阳医学院学报,2014,39(6):930-932.
[15]王芬,鲁菊香,梁水英,等.妊娠期梅毒70例临床分析[J].中国妇幼保健杂志,2012,27(31):4881-4883.
[2]孙杨燕,苏慧,凌静,等.妊娠合并梅毒105例流行特征及妊娠结局分析[J].中国妇幼健康研究,2014,25(5):758-760.
[3]郭玲.妊娠合并梅毒患者不良妊娠结果及影响因素分析[J].中国现代医生2015,53(18):76-79.
[4]乐杰,谢幸,林仲秋.妊娠合并性传播疾病[J].妇产科学,2008,6:165-166.
[5]陈访梅,黄小雄.妊娠期梅毒早期干预与晚期干预效果的回归分析[J].中国生育健康杂志,2015,26(2):166-168.
[6]付翰林,刘晓英,秦家碧,等.我国妊娠梅毒中先天梅毒报告发病率的Meta分析[J].中华传染病杂志,2015,33(6):363-368.
[7]2011~2014年河南省孕产妇感染率[J].中华疾病控制杂志,2015,19(8):849-850,859.
[8]周红.婚前医学检查传染病筛查分析[J].中外健康文摘,2013,10(38):134-135.
[9]李焱冰.从疾病检出率看婚检的必要性[J].医学信息,2015,28(43):346.
[10]熊庆,吴康敏.有关传染病的婚育医学意见[J].妇女保健学,2007,9:92-95.
[11]熊庆,吴康敏.妊娠合并性传播疾病对母儿的影响[J].妇女保健学,2007,9:140-141.
[12]林松,全钰平.妊娠梅毒与先天梅毒[J].中国妇幼健康研究,2013,4:618-620.
[13]邱琇,王临虹.妊娠梅毒对HIV母婴传播的影响[J].中国艾滋病性病,2008,14(3):308-310.
[14]陈璇,驱梅.治疗时机对妊娠合并梅毒孕妇妊娠结局的影响[J].贵阳医学院学报,2014,39(6):930-932.
[15]王芬,鲁菊香,梁水英,等.妊娠期梅毒70例临床分析[J].中国妇幼保健杂志,2012,27(31):4881-4883.