Sheffield Jeanne S, Sánchez Pablo J, Morris George, Maberry Mark, Zeray Fiker, McIntire Donald D, Wendel George D
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032, USA.
Am J Obstet Gynecol. 2002 Mar;186(3):569-73. doi: 10.1067/mob.2002.121541.
The purpose of this study was to characterize pregnancies that were complicated by maternal syphilis that had been treated before delivery in which the newborn infant was diagnosed with congenital syphilis.
Prospective surveillance from January 1, 1982, to December 31, 1998, involved women who received antenatal treatment for syphilis. Infants who were born with congenital syphilis were identified by clinical or laboratory criteria. Antepartum factors such as gestational age, time to delivery and VDRL titers were then analyzed and compared with those of women who had been treated and who were delivered of an uninfected infant. The 1:1 match was based on the stage of syphilis and the gestational age at treatment.
Forty-three women who received antepartum therapy for syphilis were delivered of an infant with congenital syphilis. Most of the women had been treated for early syphilis; the mean gestational age at treatment was 30.3 weeks. Thirty-five percent of the women were treated >30 days before delivery. Fifty-six percent of the infants were preterm. The 1:1 match revealed that treatment and delivery high VDRL titers, prematurity, and a short interval from treatment to delivery were significantly different in those infants who were diagnosed with congenital syphilis.
High VDRL titers at treatment and delivery, earlier maternal stage of syphilis, the interval from treatment to delivery, and delivery of an infant at < or =36 weeks' gestation are associated with the delivery of a congenitally infected neonate after adequate treatment for maternal syphilis.
本研究旨在描述分娩前已接受治疗但新生儿被诊断为先天性梅毒的母亲梅毒并发症妊娠情况。
1982年1月1日至1998年12月31日的前瞻性监测涉及接受梅毒产前治疗的妇女。患有先天性梅毒的婴儿通过临床或实验室标准进行识别。然后分析诸如孕周、分娩时间和性病研究实验室（VDRL）滴度等产前因素，并与接受治疗且分娩出未感染婴儿的妇女的这些因素进行比较。1:1匹配基于梅毒分期和治疗时的孕周。
43名接受梅毒产前治疗的妇女分娩出患有先天性梅毒的婴儿。大多数妇女接受的是早期梅毒治疗；治疗时的平均孕周为30.3周。35%的妇女在分娩前>30天接受治疗。56%的婴儿为早产儿。1:1匹配显示，在被诊断为先天性梅毒的婴儿中，治疗和分娩时的高VDRL滴度、早产以及治疗至分娩的间隔时间存在显著差异。
治疗和分娩时的高VDRL滴度、母亲梅毒的早期阶段、治疗至分娩的间隔时间以及妊娠<或=36周时分娩与母亲梅毒经过充分治疗后分娩出先天性感染新生儿有关。
