广东省妊娠合并梅毒母婴传播影响因素分析

Influencing factors for mother to child transmission of syphilis in pregnancy in Guangdong

  • 摘要:
      目的   分析广东省梅毒感染孕产妇的特征及其母婴传播影响因素,为广东省消除母婴传播政策制定提供依据。
      方法   以2014年1月1日至2021年2月1日广东省发生胎传梅毒的感染孕产妇为病例组,另以同地区、同分娩年度为匹配条件,筛选出未发生胎传梅毒的梅毒感染孕妇为对照组。 对相关危险因素进行单因素和多因素条件logistic回归分析。
      结果   多因素条件logistic回归分析显示,同≤20岁年龄组的孕产妇相比,21~25岁(OR=0.537,95%CI:0.341~0.845)、26~30岁(OR=0.43,95%CI:0.272~0.679)、31~35岁(OR=0.322,95%CI:0.202~0.512)和≥36岁者(OR=0.321,95%CI:0.194~0.532)发生母婴传播的风险均较低;既往未发现患梅毒的孕产妇发生母婴传播的风险较高(OR=1.837,95%CI:1.352~2.495);同在孕期就已经诊断患病的孕产妇相比,产时和产后诊断患梅毒的孕产妇发生梅毒母婴传播的风险均较高(OR=2.026,95%CI:1.472~2.790)、(OR=1.951,95%CI:1.333~2.856);同孕早期进行治疗的孕产妇相比,孕中期和孕晚期进行治疗孕产妇发生母婴传播的风险较高(OR=3.712,95%CI:1.977~6.970)、(OR=11.531,95%CI:6.363~20.894)。
      结论   在消除梅毒母婴传播的工作中需加强对低龄孕产妇梅毒等性病防治的健康教育,提高梅毒防病知识。 妊娠合并梅毒早发现、早诊断、早治疗是降低梅毒母婴传播的关键,通过早期梅毒筛查、诊断和治疗能够有效的降低梅毒母婴传播发生的风险。

     

    Abstract:
      Objective   To analyze the characteristics of pregnant women infected with syphilis and the influencing factors of mother to child transmission in Guangdong province, and provide evidence for the development of policies form the elimination of the mother to child transmission.
      Methods   Infected pregnant women who developed fetal transmitted syphilis from January 1, 2014 to February 1, 2021 in Guangdong Province were selected as the case group, and another pregnant women with syphilis infection who did not develop fetal transmitted syphilis were screened as the control group using the same region and year of delivery as matching conditions.
      Results   Multivariate conditional logistic regression analysis showed that compared with pregnant women aged ≤20 years, the risk for mother to child transmission of syphilis was lower in those aged 21−25 years (OR=0.537, 95% CI: 0.341−0.845), 26−30 years (OR=0.43, 95% CI: 0.272−0.679), 31−35 years (OR=0.322, 95% CI: 0.202−0.512) and ≥36 years (OR=0.321, 95% CI: 0.194−0.532); The risk for the mother to child transmission in pregnant women with non-diagnosed syphilis was higher (OR=1.837, 95% CI: 1.352−2.495); Compared with the pregnant women who were diagnosed with syphilis during pregnancy, the pregnant women who were diagnosed with syphilis during labor and after delivery had higher risk of mother to child transmission of syphilis (OR=2.026, 95% CI: 1.472−2.790), (OR=1.951, 95% CI: 1.333−2.856). Compared with the pregnant women receiving treatment in the first trimester, the pregnant women receiving treatment in the second and third trimesters had higher risk of mother to child transmission of syphilis (OR=3.712, 95% CI: 1.977−6.970), (OR=11.531, 95% CI: 6.363−20.894).
      Conclusion   In the elimination of mother to child transmission of syphilis, it is necessary to strengthen the health education about the prevention and treatment of sexually transmitted diseases, such as syphilis, in young pregnant women, and improve their awareness of syphilis prevention. Early detection, diagnosis and treatment of syphilis in pregnancy are essential to reduce mother to child transmission of syphilis. Early screening, diagnosis and treatment of syphilis can effectively reduce the risk of mother to child transmission of syphilis

     

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