妊娠合并梅毒孕妇不良妊娠结局的影响因素分析  

Analysis of adverse pregnancy outcomes and influencing factors in pregnant patients with syphilis

作　　者：肖培[1] 程龙慧[1] 魏敏[1] 许晓红[1] XIAO Pei;CHENG Longhui;WEI Min;XU Xiaohong(Anhui Provincial Women and Children Health Care Hospital,Women and Children Health Care Hospital Affiliated to Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽省妇幼保健院安徽医科大学附属妇幼保健院

出　　处：《中国艾滋病性病》2018年第11期1135-1138,共4页Chinese Journal of Aids & STD

基　　金：安徽省“十三五”医疗卫生重点培育专科资助~~

摘　　要：目的探讨妊娠合并梅毒孕妇不良妊娠结局的影响因素,为防治不良妊娠结局提供新的证据。方法选择2014年1月至2017年10月入院分娩的135例妊娠合并梅毒孕妇,分析妊娠合并梅毒孕妇的年龄、孕次、产次、梅毒甲苯胺红不加热血清试验(TRUST)滴度、梅毒治疗情况与不良妊娠结局。结果135例妊娠合并梅毒患者中,发生不良妊娠结局33例(24.44%)。其中早产儿等新生儿不良健康状况22例(16.30%),自然流产和死胎11例(8.15%)。孕妇TRUST高滴度(≥1:16)组,新生儿不良健康状况发生率(40.00%)以及自然流产、死胎发生率(21.05%)均高于低滴度(≤1:8)组(14.68%和6.03%)。孕妇TRUST高滴度组新生儿出生体重(2.91±1.02)kg,低于低滴度组的(3.56±0.54)kg(t=2.328,P<0.05)。未治疗组新生儿不良健康状况发生率最高(53.33%),其次为孕中晚期治疗的孕妇(16.90%),孕早期治疗的孕妇发生率最低(5.26%)(X^2=17.109,P<0.05)。孕早期治疗组新生儿出生体重(3.44±0.43)kg、孕中晚期治疗组新生儿出生体重(3.34±0.64)kg均高于未治疗组(2.94±0.75)kg(F=3.567,P<0.05)。孕早期治疗组平均孕周(276.87±9.51)天、孕中晚期治疗组平均孕周(272.74±14.54)天,均高于未治疗组(262.40±20.28)天(F=5.715,P<0.05)。初次怀孕患者的自然流产和死胎的发生率(21.95%)高于多次怀孕患者(2.13%)(X^2=14.990,P<0.05)。结论妊娠合并梅毒孕妇TRUST高滴度(≥1:16),未进行治疗或抗梅毒治疗时机晚,是不良妊娠结局的危险因素。治疗时机越早,妊娠结局越好。Objective To explore the adverse pregnancy outcomes and the risk factors of pregnant patients with syphilis,and to provide evidence for future prevention and treatment.Methods The data of 135 pregnant women with syphilis was collected from Jan.2014 to Oct.2017 in our hospital and analysis was made on the maternal age,gravidity,production time,TRUST serum titer,syphilis treatment status,and pregnancy outcomes.Results Out of the 135 cases of pregnancy complicated with syphilis,33 cases(24.44%)had adverse pregnancy outcomes,including 22 cases(16.30%)of poor health status of newborns,and 11 cases of spontaneous abortion and stillbirth(8.15%).In the TRUST high titer group,the incidence of poor health status(40.00%)and spontaneous abortion and stillbirth rate(21.05%)were higher than those in the low titer group(14.68% and 6.03%);and the birth weight of newborns(2.91±1.02 kg)was lower than that of the low titer group(3.56±0.54 kg)(t=2.328,P<0.05).The highest incidence(53.33%)of neonatal poor health status was found in the untreated group,followed by that in the group of pregnant women in the advanced stages of pregnancy(16.90%).The incidence in early pregnancy was lowest(5.26%)(χ~2=17.109,P<0.05).The neonatal birth weight in early pregnancy treatment group was 3.44±0.43 kg and that of pregnancy middle-late treatment group was 3.34±0.64 kg,higher than those of no treatment group(2.94±0.75 kg)(F=3.567,P<0.05).The gestational age of early pregnancy treatment group was 276.87±9.51 dand that in pregnancy middle-late treatment group was 272.74 ±14.54 d,higher than those of no treatment group(262.40±20.28 d,F=5.715,P<0.05).The incidence of spontaneous abortion and stillbirth(21.95%)in the first-time pregnant patients was higher than that of more than once pregnancies(2.13%,χ~2=14.990,P<0.05).Conclusion Risk factors for adverse pregnancy outcomes include TRUST serum titer≥1∶16,late and/or no treatment.The earlier the treatment,the better the pregnancy outcome.

关 键 词：妊娠合并梅毒 不良妊娠结局 影响因素 

分 类 号：R759[医药卫生—皮肤病学与性病学]