339例妊娠期梅毒母婴传播的干预研究

目的探讨妊娠期梅毒检出率和母婴传播规律及其干预技术。方法采用流行病学调查与防治结合交叉进行，应用回顾、前瞻性结合的研究方法，对梅毒患者受孕或孕期产科检查时确诊为妊娠期梅毒共339例，进行孕期及新生儿治疗和干预、随访观察。结果妊娠期梅毒检出率为2．33％；孕母治疗时机与新生儿脐带血梅毒快速血浆反应素（RPR）阳性的关系密切，治疗后结婚生育，其新生儿RPR脐带血阳性率最低；新生儿脐带血RPR阳性率随孕母RPR滴度升高而升高，孕母RPR滴度越高围产儿预后越差。结论孕母血RPR滴度和治疗时机与新生儿脐带血RPR阳性的关系密切，治疗后妊娠分娩是阻断母婴传播的有力措施。

An intervention study on preventing maternal-fetal transmission of syphilis during pregnancy

Objective To study the prevalence and principal rules of women with syphilis during pregnancy and to develop relative methods to prevent maternal-fetal transmission. Methods A nested case control study on epidemiologic research was used based on review and preview methods on prevention and cure. Targeting pregnant women with syphilis diagnosed during premarital or pregnancy stages and were identified through rapid plasma reagin test (RPR) but confirmed by treponema pallidum test (TP) ,a total number of 339 women receiving treatment, intervention and being followed throughout the pregnant and neonatal periods. Results The prevalence of syphilis in pregnancy was 2.33% , and the positive rate in neonatal cord blood was closely associated with the opportunity of getting maternal treatment. The lowest RPR positive rate was among these women who got pregnant after receiving the treatment. The RPR positive rate of neonatal cord blood was positively relative to the mother's RPR titer. The higher was the mother's blood RPR titer, the worse the prenatal prognosis would turn to. Conclusion Mother's blood RPR titer and the opportunity of getting treatment were strongly associated with the positive rate in neonatal cord blood. Pregnancy after receiving the treatment was a powerful measure to prevent the maternal-fetal transmission of syphilis.