2015-2020年广东省梅毒感染孕产妇不良妊娠结局状况及影响因素分析

朱元浩 高峰 张书豪 饶金 高爽

朱元浩, 高峰, 张书豪, 等. 2015-2020年广东省梅毒感染孕产妇不良妊娠结局状况及影响因素分析[J]. 疾病监测, 2022, 37(12): 1530-1535. doi: 10.3784/jbjc.202207050312
引用本文: 朱元浩, 高峰, 张书豪, 等. 2015-2020年广东省梅毒感染孕产妇不良妊娠结局状况及影响因素分析[J]. 疾病监测, 2022, 37(12): 1530-1535. doi: 10.3784/jbjc.202207050312
Zhu Yuanhao, Gao Feng, Zhang Shuhao, et al. Adverse pregnancy outcomes and influencing factors in pregnant women suffered from syphilis in Guangdong, 2015−2020[J]. Dis Surveill, 2022, 37(12): 1530-1535. doi: 10.3784/jbjc.202207050312
Citation: Zhu Yuanhao, Gao Feng, Zhang Shuhao, et al. Adverse pregnancy outcomes and influencing factors in pregnant women suffered from syphilis in Guangdong, 2015−2020[J]. Dis Surveill, 2022, 37(12): 1530-1535. doi: 10.3784/jbjc.202207050312

2015-2020年广东省梅毒感染孕产妇不良妊娠结局状况及影响因素分析

doi: 10.3784/jbjc.202207050312
详细信息
    作者简介:

    朱元浩,男,江西省上饶市人,硕士,主要从事传染病防治工作,Email:2770165925@qq.com

    通讯作者:

    高爽,Tel:020−39151937, Email:gaoshuang020@126.com

  • 中图分类号: R211; R759.1

Adverse pregnancy outcomes and influencing factors in pregnant women suffered from syphilis in Guangdong, 2015−2020

More Information
  • 摘要:   目的   分析广东省梅毒感染孕产妇的感染特征和不良妊娠结局的影响因素,为制定降低不良妊娠结局发生的政策提供依据。  方法   从“全国预防艾滋病、梅毒和乙肝母婴传播信息管理系统”中收集2015—2020年广东省梅毒感染孕产妇及所生新生儿的相关信息,对梅毒感染孕产妇不良妊娠结局的相关危险因素进行χ2检验和多因素logistic回归分析。  结果   不同年龄段、文化程度、婚姻状态、既往诊断情况、本次诊断时期、本次诊断梅毒分期、治疗情况、初次治疗时期发生不良妊娠的差异有统计学意义(P<0.05);多因素logistic回归分析显示,年龄≤20岁、文化程度小学及以下者发生不良妊娠的风险较大;既往未诊断梅毒者发生不良妊娠的风险较大(OR=1.350,95%CI:1.202~1.517);产时、产后诊断感染者较孕期诊断者发生不良妊娠的风险大;不在婚者较在婚者发生不良妊娠的风险大(OR=1.280,95%CI:1.027~1.420);本次诊断为Ⅱ、 Ⅲ期梅毒者较隐性梅毒者发生不良妊娠的风险大(OR=1.882,95%CI:1.039~3.195);未进行治疗者不良妊娠发生的风险较大(OR=3.465,95%CI:2.508~4.786);孕晚期再治疗者较孕早期治疗者发生不良妊娠的风险大(OR=2.245,95%CI=1.850~2.724)。  结论   年龄、文化程度、婚姻状况、诊断与治疗时期是梅毒感染孕产妇发生不良妊娠结局的影响因素。早期筛查、诊断并及时进行规范治疗对阻断梅毒母婴传播及预防不良妊娠结局具有重要意义。
  • 表  1  不同年份梅毒感染孕产妇治疗情况及不良妊娠结局情况比较

    Table  1.   Comparison of treatment and adverse pregnancy outcomes of pregnant women suffered from syphilis in different years

    年份报告病例数
    (例)
    实施治疗发生不良妊娠结局
    例数
    (例)
    治疗率
    (%)
    例数
    (例)
    发病率
    (%)
    20151 7671 43281.04 17910.13
    20163 4532 90484.103038.77
    20173 2042 81787.922277.08
    20183 3302 97989.462357.06
    20193 5633 23590.792567.18
    20203 5953 41194.882145.95
    合计18 91216 77888.721 4147.48
    下载: 导出CSV

    表  2  不同特征梅毒感染孕产妇发生不良妊娠结局情况的比较

    Table  2.   Comparison of adverse pregnancy outcomes among pregnant women suffered from syphilis with different characteristics

     特征调查数(例)构成比(%)不良妊娠结局
    病例数(例)发生率(%)χ2P
    年龄组(岁)54.162<0.01
      0~1 2216.4615212.45
     21~4 22522.343337.88
     26~5 12627.103506.83
     31~4 64624.573026.50
     36~3 69419.532777.50
    民族0.0040.950
     汉族17 60793.1013177.48
     其他1 3056.90977.43
    文化程度46.445<0.01
     小学及以下2 07210.9622210.71
     初/高中14 08374.461 0137.19
     大学及以上1 6478.71865.22
     不详1 1105.87938.38
    职业3.0270.220
     农/渔/牧民2 37012.531797.55
     家务及待业10 66156.378247.73
     其他5 88131.104116.99
    婚姻状况29.921<0.01
     在婚16 44686.961 1637.07
     不在婚2 46613.0425110.18
    产次0.7390.390
     初产妇5 99931.724637.72
     经产妇12 91368.289517.37
    既往诊断梅毒67.517<0.01
     是8 95347.345215.82
     否9 95952.668938.97
    本次诊断梅毒时期91.656<0.01
     孕期15 01979.429846.56
     产时2 66314.0829311.00
     产后1 1636.1513211.35
     不详670.3557.46
    本次诊断梅毒分期34.084<0.01
     隐性16 58687.701 1737.07
     Ⅰ期5773.05549.22
     Ⅱ/Ⅲ期1140.601513.16
     不详16358.6517210.58
    感染途径2.6310.621
     性传播7 15937.865457.61
     血液传播1160.611210.35
     母婴传播1000.5366.00
     其他720.3879.72
     不详11 46560.628447.36
    接受治疗49.414<0.01
     是16 77888.721 1747.00
     否2 13411.2824011.25
    首次治疗时期230.641<0.01
     孕早期3 49618.481714.89
     孕中期8 33044.054815.77
     孕晚期3 62919.1947012.95
     孕前期640.3457.81
     其他3 39317.942878.46
    下载: 导出CSV

    表  3  梅毒感染孕产妇发生不良妊娠结局影响因素分析

    Table  3.   Influencing factors of adverse pregnancy outcome in pregnant women suffered from syphilis

     影响因素β$s_{\bar x}$Wald χ2POR值(95%CI
    年龄组(岁)
      0~1.000
     21~−0.2580.1125.2860.0210.772(0.620~0.963)
     26~−0.3590.1149.8810.0020.698(0.558~0.874)
     31~−0.4430.11714.322<0.010.642(0.510~0.808)
     36~−0.3640.1189.4440.0020.695(0.551~0.877)
    文化程度
     小学及以下1.000
     初/高中−0.2780.08111.8770.0010.757(0.647~0.887)
     大学及以上−0.4190.1359.5770.0020.658(0.504~0.858)
    婚姻
     在婚1.000
     不在婚0.1890.0835.2270.0221.280(1.027~1.420)
    既往诊断
     是1.000
     否0.3000.06025.459<0.011.350(1.202~1.517)
    本次诊断时期
     孕期1.000
     产时0.3060.08413.424<0.011.358(1.153~1.600)
     产后0.2890.1126.6810.0011.335(1.072~1.663)
    本次诊断梅毒分期
     隐性1.000
     Ⅱ/Ⅲ期0.6000.2874.3800.0361.822(1.039~3.195)
     不详0.2790.0899.8830.0021.322(1.111~1.572)
    接受治疗
     是1.000
     否1.2430.16556.847<0.013.465(2.508~4.786)
    首次治疗时期
     孕早期1.000
     孕晚期0.8090.09967.063<0.012.245(1.850~2.724)
    下载: 导出CSV
  • [1] 国家卫生健康委员会疾病预防控制局. 2020年全国法定传染病疫情概况[J]. 中国病毒病杂志,2021,11(2):111.

    Disease Prevention and Control Bureau of the National Health Commission. Overview of national epidemic situation of legal infectious diseases in 2020[J]. Chin J Viral Dis, 2021, 11(2): 111.
    [2] Newman L, Kamb M, Hawkes S, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data[J]. PLoS Med, 2013, 10(2): e1001396. DOI:  10.1371/journal.pmed.1001396.
    [3] Wang AL, Qiao YP, Wang LH, et al. Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China[J]. Bull World Health Organ, 2015, 93(1): 52–56. DOI:  10.2471/BLT.14.139626.
    [4] Li Z, Wang Q, Qiao Y, et al. Incidence and associated predictors of adverse pregnancy outcomes of maternal syphilis in China, 2016−19: a Cox regression analysis[J]. BJOG, 2021, 128(6). DOI: 10.1111/1471−0528.16554.
    [5] Qin JB, Yang TB, Xiao SY, et al. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis[J]. PLoS One, 2017, 9(7): e102203. DOI:  10.1371/journal.pone.0102203.
    [6] Gomez GB, Kamb ML, Newman LM, et al. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis[J]. Bull World Health Organ, 2013, 91(3): 217–226. DOI:  10.2471/BLT.12.107623.
    [7] 中华人民共和国国家卫生健康委员会. 国家卫生计生委办公厅关于全面开展预防艾滋病、梅毒和乙肝母婴传播工作的通知[EB/OL]. (2015-06-16)[2022-10-12]. http://www.nhc.gov.cn/fys/s3581/201506/4f2123fa955a44afa75a75da2ad35d6e.shtml.

    National Health Commission of the People's Republic of China. Implementation plan for prevention of mother to child transmission of AIDS, syphilis and hepatitis B (2015 Edition)[EB/OL]. (2015-06-16)[2022-10-12]. http://www.nhc.gov.cn/fys/s3581/201506/4f2123fa955a44afa75a75da2ad35d6e.shtml.
    [8] 白冰, 刘新彬, 刘鑫, 等. 妊娠合并梅毒的不良妊娠结局及其影响因素[J]. 中国妇幼保健,2017,32(2):251–253. DOI:10.7620/zgfybj.j.issn.1001−4411.2017.02.13.

    Bai B, Liu XB, Liu X, et al. Adverse pregnancy outcomes of pregnant syphilis and the influencing factors[J]. Mater Child Health Care China, 2017, 32(2): 251–253. DOI: 10.7620/zgfybj.j.issn.1001−4411.2017.02.13.
    [9] 叶凤霞, 宋水勤. 梅毒孕妇不良妊娠结局的影响因素分析[J]. 山西医药杂志,2016,45(19):2302–2305. DOI:10.3969/j.issn.0253−9926.2016.19.038.

    Ye FX, Song SQ. Analysis on Influencing Factors of adverse pregnancy outcomes of pregnant women with syphilis[J]. Shanxi Med J, 2016, 45(19): 2302–2305. DOI: 10.3969/j.issn.0253−9926.2016.19.038.
    [10] 郭晓嘉, 柏兴建, 刘惠, 等. 2011年和2020年重庆市不同人群梅毒防治知识知晓率调查[J]. 中国艾滋病性病,2021,27(8):890–892. DOI: 10.13419/j.cnki.aids.2021.08.23.

    Guo XJ, Bai XJ, Liu H, et al. Investigation on knowledge of syphilis prevention and control in different population groups in Chongqing in 2011 and 2020[J]. Chin AIDS STD, 2021, 27(8): 890–892. DOI:  10.13419/j.cnki.aids.2021.08.23.
    [11] 肖雪, 周燕媚, 孙雯, 等. 2009—2013年妊娠合并梅毒孕妇及围产儿感染因素的调查[J]. 南方医科大学学报,2014,34(1):144–146. DOI:10.12122/j.issn.1673−4254.2014.01.033.

    Xiao X, Zhou YM, Sun W, et al. Prevalence of syphilis during pregnancy and risk factors for maternal and perinatal infections: a 2009-2013 survey[J]. J Southern Med Univ, 2014, 34(1): 144–146. DOI: 10.12122/j.issn.1673−4254.2014.01.033.
    [12] 古亦斌, 李阳, 朱丽萍, 等. 上海市2013年至2015年梅毒感染孕产妇治疗情况及其不良妊娠结局相关因素分析[J]. 中华传染病杂志,2019,37(4):214–219. DOI:10.3760/cma.j.issn.1000−6680.2019.04.005.

    Gu YB, Li Y, Zhu LP, et al. Treatment status of maternal syphilis infection and factors associated with their adverse pregnant outcomes in Shanghai during 2013–2015[J]. Chin J Infect Dis, 2019, 37(4): 214–219. DOI: 10.3760/cma.j.issn.1000−6680.2019.04.005.
    [13] 吴肖冰, 冯铁建, 洪福昌, 等. 深圳市妊娠梅毒及相关不良妊娠结局的疾病负担估计[J]. 中国艾滋病性病,2015,21(8):714–717. DOI: 10.13419/j.cnki.aids.2015.08.18.

    Wu XB, Feng TJ, Hong FC, et al. Estimation on the burden of syphilis in pregnancy and associated adverse pregnancy outcomes in Shenzhen, China[J]. Chin AIDS STD, 2015, 21(8): 714–717. DOI:  10.13419/j.cnki.aids.2015.08.18.
    [14] Zhang X, Yu Y, Yang HJ, et al. Surveillance of maternal syphilis in china: pregnancy outcomes and determinants of congenital syphilis[J]. Med Sci Monitor, 2018, 24: 7727–7735. DOI:  10.12659/MSM.910216.
    [15] 秦家碧, 杨土保, 谭红专, 等. 孕产妇梅毒患者不良妊娠结局发生率的系统综述和Meta分析[J]. 中华皮肤科杂志,2015,48(7):512–515. DOI:10.3760/cma.j.issn.0412−4030.2015.07.023.

    Qin JB, Yang TB, Tan HZ, et al. Systematic review and meta-analysis of the incidence of adverse pregnancy outcomes in pregnant women with syphilis[J]. Chin J Dermatol, 2015, 48(7): 512–515. DOI: 10.3760/cma.j.issn.0412−4030.2015.07.023.
    [16] Berman SM. Maternal syphilis: pathophysiology and treatment[J]. Bull World Health Organ, 2004, 82(6): 433–438.
    [17] Qin JB, Feng TJ, Yang TB, et al. Risk factors for congenital syphilis and adverse pregnancy outcomes in offspring of women with syphilis in Shenzhen, China: a prospective nested case-control study[J]. Sex Transm Dis, 2014, 41(1): 13–23. DOI:  10.1097/OLQ.0000000000000062.
    [18] 刘斌, 杨森. 不同孕期治疗妊娠梅毒对妊娠结局的影响[J]. 中国麻风皮肤病杂志,2017,33(2):92–93.

    Liu B, Yang S. Influence of treatment of pregnant syphilis on the outcome of pregnancy in different gestation[J]. Chin J Leprosy Dermatol, 2017, 33(2): 92–93.
    [19] 陈冠锋, 郭庆云, 邵森, 等. 浙江地区梅毒感染孕产妇治疗现状及不良妊娠结局因素分析[J]. 中国计划生育学杂志,2020,28(9):1346–1350. DOI:10.3969/j.issn.1004−8189.2020.09.004.

    Chen GF, Guo QY, Shao S, et al. Analysis of the treatment status and adverse pregnancy outcomes of pregnant women with syphilis infection in Zhejiang region[J]. Chin J Family Plann, 2020, 28(9): 1346–1350. DOI: 10.3969/j.issn.1004−8189.2020.09.004.
    [20] 张艳林, 吴剑波. 妊娠梅毒不同时期治疗对妊娠结局的影响[J]. 黑龙江医药,2020,33(3):583–585. DOI: 10.14035/j.cnki.hljyy.2020.03.045.

    Zhang YL, Wu JB. Effect of treatment of pregnant syphilis at different stages on pregnancy outcome[J]. Heilongjiang Med J, 2020, 33(3): 583–585. DOI:  10.14035/j.cnki.hljyy.2020.03.045.
    [21] 中华人民共和国国家卫生健康委员会. 梅毒诊断(代替WS 273-2007)[EB/OL]. (2018-08-01)[2022-10-12]. http://www.nhc.gov.cn/wjw/s9491/201803/5103a5425f9e47d29b91de38434b7f74.shtml.

    National Health Commission of the People's Republic of China. Syphilis diagnosis (replacing WS 273-2007)[EB/OL]. (2018−08−01)[2022-10-12]. http://www.nhc.gov.cn/wjw/s9491/201803/5103a5425f9e47d29b91de38434b7f74.shtml.
  • 加载中
计量
  • 文章访问数:  206
  • HTML全文浏览量:  116
  • PDF下载量:  15
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-07-05
  • 网络出版日期:  2022-11-08
  • 刊出日期:  2022-12-01

目录

    /

    返回文章
    返回

    在线交流

    防诈骗公告

    大家好:近期有不法分子以本刊编辑身份添加作者微信,请务必提高警惕!本刊关于稿件的一切事项通知均采用编辑部唯一邮箱(jbjc@icdc.cn)和座机(010-58900732)联系作者,且在录用稿件后仅收取版面费,无其他任何名目费用(如审稿费和加急费等),非编辑部邮箱发送的本刊收费用通知等均为诈骗,不要随意汇入款项!如有可疑及时致电编辑部核实确认!