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目的:分析对深圳市福田区921例妊娠梅毒干预效果,为进一步制定预防与控制梅毒母婴传播项目策略提供依据。方法:对921例妊娠梅毒患者依据注射苄星青霉素的时间分为早期干预组(<孕28周)、晚期干预组(孕28～35周)及未干预/不完整干预组,并依据妊娠梅毒患者甲苯胺红不加热血清试验(TRUST)滴度水平分为低滴度组(≤1∶4)、中滴度组(1∶8～1∶16)及高滴度组(>1∶16),研究相同干预时机不同血清TRUST水平对患者妊娠结局的影响,以及相同滴度水平下不同干预时机对患者妊娠结局的影响。结果:665例接受规范治疗干预患者未发生先天梅毒、早产及新生儿死亡;256例未干预/不完整干预患者先天梅毒、早产、低体重出生儿、新生儿死亡及死胎发生率分别为3.13%、3.91%、6.25%、1.56%、9.38%。患者在早期(<28周)或晚期(28～35周)接受规范干预均能够获得满意的干预效果,未干预/不完整干预者不良妊娠结局发生率高于规范干预者(P<0.05);未干预/不完整干预妊娠梅毒患者发生不良结局的危险性与血清滴度水平有关(P<0.05)。结论:规范长效青霉素治疗能使妊娠梅毒患者避免发生不良妊娠结局,即使在孕28～35周接受规范干预仍能获得理想效果。妊娠梅毒患者发生先天梅毒儿、早产、死胎及新生儿死亡的危险性与血清TRUST滴度水平相关。
Objective: To analyze the effect of 921 pregnancy syphilis interventions in Futian District, Shenzhen, and provide evidences for further prevention and control strategies of syphilis mother-to-child transmission. Methods: 921 pregnant women with syphilis were divided into early intervention group (<28 weeks), late intervention group (28-35 weeks) and non-intervention group according to the time of injecting penicillin. The TRUST titers of patients were divided into low titers (≤1: 4), middle titers (1:8 to 1:16) and high titers (> 1:16) ) To study the influence of different levels of serum TRUST on the pregnancy outcome of patients with the same intervention timing and the impact of different intervention timings on the pregnancy outcome of the same titer level. Results: No congenital syphilis, premature birth and neonatal death occurred in 665 patients receiving normative treatment intervention. The incidence of congenital syphilis, premature birth, low birth weight, neonatal death and stillbirth in 256 patients without intervention / incomplete intervention were 3.13% , 3.91%, 6.25%, 1.56%, 9.38%. Patients receiving normative intervention in early (<28 weeks) or late (28th to 35th weeks) patients achieved satisfactory results. The incidence of adverse pregnancy outcomes in non - intervention and incomplete intervention groups was higher than that in normative intervention group (P <0.05). The risk of untreated / incomplete intervention in patients with syphilis and adverse outcomes was related to serum titer (P <0.05). Conclusion: Standard long-term penicillin treatment can prevent pregnancy-induced syphilis in patients with adverse pregnancy outcomes, even at 28 to 35 weeks pregnant with normative intervention can still get the desired effect. Pregnancy syphilis in patients with congenital syphilis, premature birth, stillbirth and neonatal mortality risk associated with serum TRUST titer.