University of Connecticut Graduate Program in Public Health, Farmington, Connecticut, United States of America.
Rev Panam Salud Publica. 2009 Sep;26(3):197-202. doi: 10.1590/s1020-49892009000900002.
A study was conducted to assess the prevalence of maternal syphilis and estimate the rate of congenital syphilis in five rural villages surrounding Jeremie, Haiti.
This research was a retrospective observational study. Data were extracted from the Haitian Health Foundation's public health database and verified through original clinical paper records, death certificates, midwife reports, and discussions with community health workers. Data were analyzed by chi-square analysis, bivariate correlations, and two-tailed t-test for independent samples.
Of the 410 women tested for syphilis, 31 (7.6%) were sero-reactive. Average gestation at time of testing was 25 weeks, which correlated with entry into prenatal care at an average of 23 weeks. Women who tested positive during pregnancy were more likely to have had a negative pregnancy outcome than those who did not (chi square = 16.4; P < 0.0001). The estimated rate of congenital syphilis in the region was 767 per 100,000 live births.
Maternal syphilis is prevalent in rural Haiti. This prevalence combined with late entry into prenatal care contributes to adverse pregnancy outcomes and a high estimated rate of congenital syphilis. More research is needed on congenital syphilis and prenatal-careseeking practices of rural Haitian women in order to understand the impact of maternal syphilis in the region and improve pregnancy outcomes.
本研究旨在评估海地杰雷米周边五个农村地区的梅毒母婴传播流行率，并估算先天性梅毒的发生率。
本研究为回顾性观察性研究。数据来自海地健康基金会公共卫生数据库，并通过原始临床病历记录、死亡证明、助产士报告以及与社区卫生工作者的讨论进行了验证。采用卡方检验、双变量相关性分析和两尾独立样本 t 检验进行数据分析。
在接受梅毒检测的 410 名女性中，有 31 名（7.6%）呈血清反应阳性。检测时的平均孕周为 25 周，这与平均在 23 周时开始产前护理的时间相对应。在怀孕期间检测呈阳性的女性比未检测呈阳性的女性更有可能出现不良妊娠结局（卡方=16.4；P<0.0001）。该地区先天性梅毒的估计发生率为每 10 万活产儿 767 例。
在海地农村地区，梅毒母婴传播较为普遍。这种流行率加上晚期进入产前护理，导致不良妊娠结局和高估计的先天性梅毒发生率。需要对先天性梅毒和海地农村地区孕妇寻求产前护理的情况进行更多研究，以便了解该地区梅毒母婴传播的影响，并改善妊娠结局。
