Tikhonova L, Salakhov E, Southwick K, Shakarishvili A, Ryan C, Hillis S
Ministry of Health of the Russian Federation.
Sex Transm Infect. 2003 Apr;79(2):106-10. doi: 10.1136/sti.79.2.106.
Reported cases of congenital syphilis in the Russian Federation increased 26-fold from 1991-9. Our objectives were to describe the frequency, risk factors, and consequences of delivering an infant with congenital syphilis among pregnant women with active syphilis.
In a retrospective record review using consecutive sampling of logs at maternity hospitals in five geographic areas, data were abstracted for 850 women with active syphilis during pregnancy who had completed >/=20 weeks' gestation. Further information was abstracted from records in antenatal clinics, dermatovenereology clinics, and paediatric hospitals. We assessed the frequency of confirmed or probable congenital syphilis, used logistic modelling to identify independent predictors for delivering a baby with congenital syphilis, and calculated the proportion of infants with congenital syphilis who experienced late fetal death (20-27 weeks), stillbirth (>/=28 weeks), or infant death.
A total of 64% (n=544) of 850 pregnant syphilis infected women delivered an infant with confirmed or probable congenital syphilis; 40% of the sample had no prenatal care. Among women with no prenatal care, 77% received either no treatment or inadequate treatment and 86% delivered an infant with congenital syphilis. Important independent and modifiable risk factors for delivery of an infant with congenital syphilis included receiving no prenatal care (adjusted OR 2.8, 95% CI 1.7 to 4.7) and having the first test for syphilis at >/=28 weeks' gestation (adjusted OR 4.0, 95% CI 2.6 to 6.0). Fatal outcomes were observed in 26% of infants with congenital syphilis, including late fetal death (7%), stillbirth (16%), or neonatal death (3%).
In the Russian Federation, the frequency of congenital syphilis is high, risk factors for congenital syphilis are modifiable, and the consequences of congenital syphilis are severe.
1991年至1999年期间，俄罗斯联邦先天性梅毒报告病例增加了26倍。我们的目的是描述患有活动性梅毒的孕妇分娩先天性梅毒婴儿的频率、危险因素及后果。
采用连续抽样法，对五个地理区域妇产医院的日志进行回顾性记录审查，提取了850名孕期患有活动性梅毒且妊娠≥20周的妇女的数据。从产前诊所、皮肤性病诊所和儿科医院的记录中提取了更多信息。我们评估了确诊或疑似先天性梅毒的频率，使用逻辑模型确定分娩先天性梅毒婴儿的独立预测因素，并计算了患有先天性梅毒的婴儿发生晚期胎儿死亡（20 - 27周）、死产（≥28周）或婴儿死亡的比例。
850名感染梅毒的孕妇中，共有64%（n = 544）分娩了确诊或疑似先天性梅毒的婴儿；40%的样本未接受产前护理。在未接受产前护理的妇女中，77%未接受治疗或治疗不足，86%分娩了先天性梅毒婴儿。分娩先天性梅毒婴儿的重要独立且可改变的危险因素包括未接受产前护理（调整后比值比2.8，95%置信区间1.7至4.7）以及在妊娠≥28周时首次进行梅毒检测（调整后比值比4.0，95%置信区间2.6至6.0）。26%的先天性梅毒婴儿出现了致命结局，包括晚期胎儿死亡（7%）、死产（16%）或新生儿死亡（3%）。
在俄罗斯联邦，先天性梅毒的发生率很高，先天性梅毒的危险因素是可以改变的，且先天性梅毒的后果很严重。
