梅毒孕妇妊娠不良结局的相关因素Logistic分析

目的 了解南通市近4年的梅毒孕妇妊娠不良结局的发生情况,重点探讨不良结局的相关影响因素,为卫生行政部门制订决策提供科学依据.方法 采用回顾性研究,以南通市2012年1月至2015年12月孕期确诊为妊娠梅毒的451例孕妇为研究对象,通过χ2检验及非条件多因素Logistic分析探讨妊娠不良结局的影响因素.结果 451例梅毒孕妇发生妊娠不良结局45例,发生率为9.98%.产时确诊梅毒感染的孕妇发生妊娠不良结局的风险高于孕早期确诊的孕妇(OR=4.703,95%CI:1.079~20.486),孕期未用药或仅用药1个疗程的孕妇妊娠不良结局发生率均高于用药2个疗程的孕妇,OR值分别为4.583和3.905,出生时快速血浆反应素环状卡片试验(RPR)值阳性的新生儿最终不良结局发生率高于阴性者(OR=3.412, 95%CI:1.295~8.987).结论 孕期尽早进行梅毒筛查、梅毒感染孕妇及早规范药物治疗是减少梅毒孕妇妊娠不良结局的有效途径.

Logistic analysis on related factors of adverse pregnancy outcomes of pregnant women with syphilis

Objective To understand the incidence of adverse pregnancy outcomes of pregnancy women with syphilis in recent 4 years in Nantong City and analyze the relevant influencing factors of adverse outcomes so as to provide scientific basis for further decision-making for health administrative departments.Methods A retrospective study was conducted on 451 pregnant women diagnosed with syphilis from January 2012 to December 2015 in Nantong City.Influencing factors of adverse pregnancy outcomes were analyzed by chi-square test and unconditional multivariate Logistic analysis.Results Among 451 cases with pregnant syphilis, 45 cases suffered adverse pregnancy outcomes and the incidence rate of adverse pregnancy outcomes was 9.98%.Risk of adverse pregnancy outcomes in pregnant women diagnosed at birth was higher than that in pregnant women diagnosed in early pregnancy (OR=4.703, 95%CI ranged 1.079 to 20.486).Incidence rate of adverse pregnancy outcomes in pregnant women who had no medication or only one course of medication was higher than that in women who took medication for two courses (OR value was 4.583 and 3.905, respectively).That in neonates with positive RPR experiment results at birth was higher than that in those with negative results (OR=3.412,95%CI ranged 1.295 to 8.987).Conclusion Early syphilis screening and early and standard drug therapy are effective ways to reduce adverse pregnancy outcomes of pregnant women with syphilis.