浙江省梅毒感染孕产妇梅毒治疗的影响因素研究  

Factors affecting the treatment of syphilis infection among pregnant and lying-in women in Zhejiang Province

作　　者：陈银炜 林聃 姚强[2] 张晓辉[1] CHEN Yinwei;LIN Dan;YAO Qiang;ZHANG Xiaohui(Department of Women's Health,Women's Hospital,School of Medicine,Zhejiang University,Hangzhou,Zhejiang 310006,China;Sichuan University,Chengdu,Sichuan 610044,China)

机构地区：[1]浙江大学医学院附属妇产科医院妇女保健部,浙江杭州310006 [2]四川大学,四川成都610044

出　　处：《预防医学》2022年第4期330-334,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省科技厅软课题(2019C35028);联合国儿童基金会消除艾滋病梅毒和乙肝母婴传播项目。

摘　　要：目的了解浙江省梅毒感染孕产妇梅毒治疗情况及影响因素,促进梅毒感染孕产妇规范治疗。方法通过浙江省预防艾滋病、梅毒和乙肝母婴传播信息系统收集2018年在浙江省分娩的梅毒感染孕产妇资料,包括年龄、文化程度、职业、民族和婚姻状况等社会人口学特征,孕产次、子女数和异常生育史等生育情况,初检孕周,以及是否梅毒治疗、是否规范治疗和梅毒抗体滴度等梅毒治疗情况;采用结构方程模型分析梅毒治疗的影响因素。结果纳入梅毒感染孕产妇2061例,年龄中位数为29岁;初检孕周为(14.33±11.85)周;孕早期(<孕13周)梅毒检测844例,占40.95%。梅毒治疗1978例,占95.97%;规范治疗1616例,占78.41%。结构方程模型分析结果显示:梅毒感染孕产妇梅毒治疗受初检孕周和生育情况的直接影响,标准化路径系数分别为-0.187和-0.157(均P<0.05);社会人口学特征通过生育情况的中介作用影响梅毒治疗,标准化路径系数为0.070(P<0.05)。结论浙江省孕产妇梅毒治疗比例超过95%,达到世界卫生组织消除梅毒母婴传播认证标准;初检孕周、生育情况和社会人口学特征是孕产妇梅毒治疗的影响因素。Objective To investigate the current status of syphilis treatment and its influencing factors among pregnant and lying-in women in Zhejiang Province,so as to promote the standardized treatment for pregnant and lying-in women with syphilis.Methods The sociodemographic characteristics(age,educational level,ethnicity,marital status,occupation),fertility(gravidity,parity,number of children,and adverse pregnancy history),gestational week at the first antenatal care visit and syphilis treatment(treatment or not,standardized treatment or not,and antibody titer)were collected from the pregnant and lying-in women with syphilis infections delivered in Zhejiang Province in 2018,based on the Zhejiang Provincial Information Management System for Prevention of Mother-to-Child Transmission of AIDS,Syphilis and Hepatitis B.Factors affecting the treatment of syphilis infections were identified using a structural-equation model.Results A total of 2061 pregnant and lying-in women with syphilis infections were included,with a median age of 29 years and a mean gestational week at the first antenatal care visit of(14.33±11.85)weeks,and there were 844 women(40.95%)diagnosed in early pregnancy(<13 weeks of gestational age).There were 1978 cases(95.97%)receiving syphilis treatment,and 1616 cases(78.41%)received standardized treatment.The structural-equation modeling analysis showed that the gestational age at the first antenatal care visit and fertility had direct impacts on the treatment of syphilis infections among pregnant and lying-in women,with standardized path coefficients of-0.187 and-0.157(both P<0.05),respectively,and the sociodemographic characteristics affected the treatment of syphilis through the mediating role of fertility,with a standardized path coefficient of 0.070(P<0.05).Conclusions The proportion of syphilis treatment is more than 95%among pregnant and lying-in women in Zhejiang Province,which achieves the required process criteria for validation of elimination of mother-to-child transmission of HIV and syphilis.Ges

关 键 词：梅毒 梅毒治疗 妊娠 母婴传播 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]