2012-2021年湖北省梅毒感染孕产妇所生围产儿死亡及影响因素  

Perinatal mortality and influencing factors among pregnant women infected with syphilis in Hubei Province from 2012 to 2021

作　　者：徐阳欢 张蕃[2] 代国红[1] 王玉红[1] 李德海 尹丹丹 卢宇翾 龚正涛[1] XU Yanghuan;ZHANG Fan;DAI Guohong;WANG Yuhong;LI Dehai;YIN Dandan;LU Yuxuan;GONG Zhengtao(Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,Hubei,China;Hubei Province Center for Disease Control and Prevention,Wuhan 430079,Hubei,China)

机构地区：[1]湖北省妇幼保健院,武汉430070 [2]湖北省疾病预防控制中心,武汉430079

出　　处：《中国艾滋病性病》2024年第3期303-307,共5页Chinese Journal of Aids & STD

基　　金：中国疾病预防控制中心妇幼保健中心“2020年度合生元母婴营养与健康研究项目”(2020FYH008)。

摘　　要：目的探讨梅毒感染孕产妇所生围产儿死亡情况及主要影响因素,为降低湖北省梅毒感染孕产妇所生围产儿死亡水平和消除梅毒母婴传播提供参考依据。方法收集2012年1月1日至2021年12月31日全国预防梅毒母婴传播管理信息系统中湖北地区报告的已分娩的梅毒感染孕产妇相关流行病学调查资料,采用趋势性χ^(2)检验和Logistic回归模型,分析梅毒感染孕产妇所生围产儿死亡情况及其影响因素。结果2012至2021年,湖北省梅毒感染孕产妇所生围产儿死亡率从39.11‰(7/179)下降至5.57‰(3/539),呈下降趋势(χ^(2)_(趋势)=9.95,P=0.002),梅毒感染孕产妇所生围产儿死亡率高于全人群围产儿死亡率。多因素分析结果显示,妊娠末次非梅血清学滴度≥1∶8(OR=5.58,95%CI:2.02~15.36)、妊娠末次非梅血清学滴度不详(OR=4.52,95%CI:1.70~12.02)、早产或低出生体质量(OR=7.21,95%CI:4.72~11.03)、新生儿窒息(OR=16.82,95%CI:8.10~34.93)、出生缺陷(OR=11.52,95%CI:5.09~26.10)均是梅毒感染孕产妇所生围产儿死亡的危险因素(P<0.05),接受治疗(OR=0.58,95%CI:0.37~0.91)是梅毒感染孕产妇所生围产儿死亡的保护因素。结论湖北省梅毒感染孕产妇所生围产儿死亡率呈逐年下降的趋势,早产/低出生体质量是梅毒感染孕产妇死亡的首要原因,重视开展科普宣教,早期检测规范治疗、积极降低非梅血清学滴度和加强新生儿保健服务质量是降低围产儿死亡发生风险的重要手段。Objective To investigate the situation on perinatal mortality of pregnant women infected with syphilis and its influencing factors,and to provide a reference for reducing the level of perinatal deaths and eliminating the motherto-child transmission in Hubei Province.Methods Epidemiological survey data on syphilis-infected pregnant women who gave birth in Hubei Province in the National Management Information System for the Prevention of Mother-to-Child Transmission of Syphilis(NPMTCT)from January 1,2012 to December 31,2021,were collected.The Chi-square test for trend and logistic regression methods were used to analyze the perinatal mortality of syphilis-infected pregnant women and the influencing factors.Results From 2012 to 2021,the perinatal mortality of pregnant women with syphilis in Hubei Province decreased significantly from 39.11‰(7/179)to 5.57‰(3/539)(χ^(2)_(trend)=9.95,P=0.002).The mortality of perinatal infants born to syphilis-infected pregnant women was higher than that of the whole population.The results of multivariate analysis results indicated that a titer of≥1∶8 in the last pregnant serological tests for non-syphilis(OR=5.58,95%CI:2.02-15.36),or an unknown titer(OR=4.52,95%CI:1.70-12.02),as well as preterm birth or low birth weight(OR=7.21,95%CI:4.72-11.03),neonatal asphyxia(OR=16.82,95%CI:8.10-34.93),birth defects(OR=11.52,95%CI:5.09-26.10)were all risk factors for perinatal death in pregnant women with syphilis infection(P<0.05),while receiving treatments(OR=0.58,95%CI:0.37-0.91)was identified as a protective factor against perinatal death in syphilitic-infected pregnant women.Conclusions The mortality of perinatal infants born to pregnant women with syphilis in Hubei Province shows a decreasing trend year by year,and preterm birth/low birth weight is the primary cause of perinatal mortality of pregnant women with syphilis.Emphasis on carrying out publicity and education,early detection and standardized treatment,reducing serological tests for non-syphilis,and strengthening the quality

关 键 词：孕产妇 梅毒感染 围产儿死亡 

分 类 号：R759.15[医药卫生—皮肤病学与性病学]