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2015年华东地区梅毒感染孕产妇人群特征分析

Characteristics of syphilis-infected pregnant women in East China in 2015

  • 摘要: 目的 了解华东地区梅毒感染孕产妇的感染特征并探讨相关影响因素。方法 利用2015年我国华东地区预防艾滋病、梅毒和乙肝母婴传播管理信息系统中梅毒感染孕产妇监测数据,对孕产妇的人口学特征、感染特征和非梅毒螺旋体抗原血清学试验滴度(非梅滴度)水平进行描述,利用Logistics回归模型对非梅滴度的影响因素进行分析。结果 2015年我国华东地区共发现9101例梅毒感染孕产妇。孕早期接受过产前检查的孕产妇4613例(50.7%),而妊娠梅毒诊断时期为孕早期者仅有2805例(30.8%)。梅毒感染途径不详的孕产妇有5640例(62.0%)。有5954例(65.4%)孕产妇的丈夫/性伴感染状态不详。孕产妇高非梅滴度(≥ 1:8)水平同年龄、婚姻状态、教育程度、初检孕周、既往梅毒感染史,以及丈夫/性伴感染状态之间存在关联。结论 梅毒感染孕产妇妊娠期梅毒诊断存在延误现象,并且存在再次感染风险。建议进一步优化预防梅毒母婴传播干预服务流程,规范咨询、诊疗和随访服务,加强性伴检测,从而有效降低先天梅毒发病风险。

     

    Abstract: Objective To understand the infection-related characteristics of syphilis-infected pregnant women in East China and its associated factors.Methods Data of syphilis-infected pregnant women in East China from the national ‘Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management’ were analyzed in our study. We described the demographic and infection-related characteristics and non-treponemal titer. We analyzed factors associated with non-treponemal titer using logistic regression model.Results There were 9101 syphilis-infected pregnant women in East China in 2015. There were 4613 (50.7%) women who received antenatal care visit in their first trimester of pregnancy, while only 2805 (30.8%) were diagnosed during the first trimester. There were 5640 (62.0%) women that were unware of their route of infection. Syphilis infection status of 5954 (65.4%) women'shusband/partners were unknown. High level of none-treponemal titer (≥ 1:8) was associated with age, marriage status, education, first antenatal care visit, syphilis infection history and husband/partner infection status.Conclusion Diagnosis delay of maternal syphilis was not rare among pregnant women. The infected pregnant women were at risk of re-infection. We suggest to further reduce congenital syphilis risks by continuing optimizing prevention of mother-to-child transmission care, standardizing counselling, diagnosis, treatment and follow-up practices, and promoting testing uptake in partners.

     

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