妊娠合并梅毒105例流行特征及妊娠结局分析

目的：通过筛查梅毒，探讨妊娠合并梅毒的流行特征及临床特点，探索降低孕产妇发病率及改善预后的有效措施。方法对2010年1月至2013年10月在江阴市人民医院就诊的妊娠合并梅毒患者105例进行回顾性分析。结果妊娠合并梅毒105例，占住院分娩总病例的6．66‰；其中潜伏期梅毒70例（66．67％），一期梅毒30例（28．57％），二期梅毒5例（4．76％）。妊娠合并梅毒的发病率呈逐年上升趋势（χ2＝12．864，P＝0．05）；外地、无固定职业、文化水平低的孕产妇妊娠合并梅毒发病率均明显高于本地、有固定职业、文化水平高者（χ2值分别为14．404、25．259、20．662，均P＜0．01）；规范治疗组、未规范治疗组和未治疗组经过比较，足月产、流产、先天梅毒儿的发生率差异均有统计学意义（χ2值分别为15．136、7．613、29．406，均P＜0．05）。结论妊娠合并梅毒的发病率逐年升高，并且以潜伏期梅毒为主，应加强孕前及孕期的梅毒筛查，早期发现梅毒并进行规范的治疗，可有效保障母婴安全。

Epidemiological characteristic and pregnancy outcomes of 105 cases of pregnancy complicated with syphilis

Objective To investigate the epidemiological and clinical characteristics of pregnancy complicated with syphilis by syphilis screening, and to explore effective measures to reduce maternal morbidity and improve prognosis.Methods Retrospective analysis was carried out on 105 cases of pregnancy complicated with syphilis diagnosed in Jiangyin Hospital Affiliated to Southeast University during the period of January to October in 2013.Results There were 105 cases of pregnancy complicated with syphilis, accounting for 6.66‰of the total cases of delivery, including 70 cases of latent syphilis （66.67%）, 30 cases of primary syphilis （28.57%） and 5 cases of secondary syphilis （4.76%）.The incidence of pregnancy associated with syphilis increased year by year （χ2 =12.864,P=0.05）.That of women living in other places, without fixed occupation and low educational level was significantly higher than that of cases living in Jiangyin, with fixed occupation and high educational level （χ2 value was 14.404, 25.259 and 20.662, respectively, all P〈0.01）.The incidence of full-term, abortion and congenital syphilis was different among standardized treatment group, non-standardized treatment group and the group without treatment （χ2 value was 15.136, 7.613 and 29.406, respectively, all P〈0.05） .Conclusion The incidence of syphilis in pregnancy increases year by year, and the latent syphilis is the major type.Syphilis screening before and during pregnancy should be strengthened.Early detection of syphilis and standardized treatment can guarantee the safety of mother and infant effectively.