妊娠合并梅毒感染孕妇不良妊娠结局影响因素的Meta分析  

Factors influencing adverse pregnancy outcomes in pregnant women with syphilis infections:A meta-analysis

作　　者：郭雅乐 李军文[2] 王兆兰 曾翔 王昆 GUO Yale;LI Junwen;WANG Zhaolan;ZENG Xiang;WANG Kun(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China;Chengdu First People's Hospital,Chengdu 610095,Sichuan,China;Chengdu Medical College,Chengdu 610500,Sichuan,China)

机构地区：[1]成都中医药大学,成都610075 [2]成都市第一人民医院,成都610095 [3]成都医学院,成都610500

出　　处：《中国艾滋病性病》2024年第1期103-109,共7页Chinese Journal of Aids & STD

摘　　要：目的系统评价梅毒感染孕妇不良妊娠结局相关的影响因素,为提高疾病监测提供依据。方法全面检索中国生物医学数据库(CBM)、中国知网(CNKI)、维普(VIP)、万方(Wanfang Data)、Pubmed、Web of Science、Co⁃chrane Library、Embase各中英文数据库,内容为关于妊娠合并梅毒感染孕妇发生不良妊娠结局影响因素的横断面研究、队列研究和病例对照研究,检索时间是从建库到2023年8月。由2名研究人员按照纳排标准核对筛选文献,并对纳入文献进行质量评价和数据提取。再运用Revman5.3对数据进行Meta分析。结果共纳入18篇文献,包括57303例患者,其中有6446例发生了不良妊娠结局。Meta分析结果显示,妊娠合并梅毒感染孕妇发生不良妊娠结局与TRUST滴度(OR=2.45,95%CI:1.95~3.09)、不在婚(OR=2.03,95%CI:1.47~2.79)、确诊时间为产后(OR=1.37,95%CI:1.11~1.71)、未治疗(OR=2.33,95%CI:1.72~3.15)、未执行随访计划(OR=0.53,95%CI:0.35~0.81)、不足1个驱梅疗程(OR=2.78,95%CI:1.64~4.72)、开始治疗孕周晚(OR=2.03,95%CI:1.63~2.52)、确诊梅毒为晚期(OR=2.07,95%CI:1.20~4.19)等因素相关;其中规范治疗(OR=0.40,95%CI:0.29~0.54)、既往感染(OR=1.13,95%CI:1.02~1.26)是发生不良妊娠的保护因素。结论妊娠期梅毒感染孕妇不良妊娠结局发生的影响因素较多,应当早期对梅毒感染孕产妇的健康状况进行筛查与评估,对存在高风险的孕妇尽早预防和干预,从而减少不良妊娠结局的发生。Objective This study systematically evaluates factors influencing adverse pregnancy outcomes in pregnant women infected with syphilis and provides evidence for improving disease surveillance.Methods The Chinese and English databases of CBM,China National Knowledge Internet(CNKI),VIP Chinese Journal Service Platform,Wanfang Data Knowledge Service Platform,PubMed,Web of Science,Cochrane Library,and Embase were comprehensively searched for cross-sectional,cohort,and case-control studies on factors influencing adverse pregnancy outcomes in pregnant women with syphilis infections.The studies included those conducted from the establishment of the databases to August 2023.Two researchers screened the literature according to the exclusion criteria and conducted quality evaluation and data extraction accordingly.Then,a meta-analysis of the data was performed using Revman 5.3.Results A total of 18 articles were included,involving 57303 patients,of whom 6446 had adverse pregnancy outcomes.The results of the meta-analysis revealed that adverse pregnancy outcomes in pregnant women with syphilis infections were associated with factors including TRUST titer(OR=2.45,95%CI:1.95-3.09),non-marital status(OR=2.03,95%CI:1.47-2.79),postpartum diagnosis(OR=1.37,95%CI:1.11-1.71),lack of treatment(OR=2.33,95%CI:1.72-3.15),non-execution of follow-up plans(OR=0.53,95%CI:0.35-0.81),less than one course of anti-syphilis treatment(OR=2.78,95%CI:1.64-4.72),starting treatment in later stages of pregnancy(OR=2.03,95%CI:1.63-2.52),and diagnosis of syphilis at an advanced stage(OR=2.07,95%CI:1.02-4.19);on the contrary,standard treatment(OR=0.40,95%CI:0.29-0.54)and previous infection(OR=1.13,95%CI:1.02-1.26)were protective factors against adverse pregnancy.Conclusions Many factors influenced adverse pregnancy outcomes in pregnant women infected with syphilis during pregnancy.To reduce the occurrence of adverse pregnancy outcomes,early screening and assessment of the health status of pregnant women infected with syphilis should be carried out,and ea

关 键 词：妊娠 梅毒感染 孕妇 不良妊娠结局 META分析 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]