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

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

  • 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。

     

    Abstract:
      Objective   To analyze the infection characteristics and the influencing factors of adverse pregnancy outcomes in pregnant women suffered from syphilis in Guangdong province, and provide evidence for the development of prevention and control measures to reduce the incidence of adverse pregnancy outcomes.
      Methods   The information of pregnant women suffered from syphilis and newborns in Guangdong from 2015 to 2020 were collected from “National Information Management System for the Prevention of Mother to Child Transmission of AIDS, Syphilis and Hepatitis B”, and χ2 test and multivariate logistic regression analysis were conducted to identify risk factors of adverse pregnancy outcomes of these pregnant women.
      Results   The results of χ2 test showed that there were significant differences in the incidence of adverse pregnancy among the pregnant women with different age, education levels, marital status, previous diagnoses, current diagnosis times, stages of syphilis in current diagnosis, treatment status and initial treatment times (P<0.05). Multivariate Logistic regression analysis showed that the risk of adverse pregnancy was higher in those aged 20 years and below and those with primary education level. Those who were not diagnosed with syphilis previously had higher risk for adverse pregnancy (OR=1.350, 95% CI: 1.202−1.517). The risk for adverse pregnancy was higher in the pregnant women diagnosed with syphilis at and after delivery than in those diagnosed during pregnancy. The unmarried women had higher risk for adverse pregnancy than the married women (OR=1.280, 95% CI: 1.027−1.420). The risk of adverse pregnancy was higher in the pregnant women with phase Ⅱ or Ⅲ syphilis than in those with recessive syphilis (OR=1.882, 95% CI: 1.039−3.195). The risk of adverse pregnancy was higher in the pregnant women without treatment (OR=3.465, 95% CI: 2.508−4.786). The risk of adverse pregnancy was higher in the pregnant women receiving treatment later in pregnancy than in patients receiving treatment early in pregnancy (OR=2.245, 95% CI: 1.850−2.724).
      Conclusion   Age, education level, marital status, diagnosis and treatment time are the influencing factors of adverse pregnancy outcomes in pregnant women suffered from syphilis. Early screening, diagnosis and timely standardized treatment are of great importance in blocking mother to child transmission of syphilis and preventing adverse pregnancy outcomes.

     

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