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先天性梅毒 - 美国,2003-2008 年。

Congenital syphilis - United States, 2003-2008.

出版信息

MMWR Morb Mortal Wkly Rep. 2010 Apr 16;59(14):413-7.

Abstract

Untreated syphilis during pregnancy, especially early syphilis, can lead to stillbirth, neonatal death, or infant disorders such as deafness, neurologic impairment, and bone deformities. Congenital syphilis (CS) can be prevented by early detection of maternal infection and treatment at least 30 days before delivery. Changes in the population incidence of primary and secondary (P&S) syphilis among women usually are followed by similar changes in the incidence of CS. To assess recent trends in CS rates, CDC analyzed national surveillance data from the period 2003--2008. This report summarizes the results of that analysis, which indicated that, after declining for 14 years, the CS rate among infants aged <1 year increased 23%, from 8.2 cases per 100,000 live births in 2005 to 10.1 during 2008. That increase followed a 38% increase in the P&S syphilis rate among females aged >or=10 years from 2004 to 2007. During 2005-2008, CS rates increased primarily in the South (from 9.6 per 100,000 live births to 15.7) and among infants born to black mothers (from 26.6 per 100,000 live births to 34.6). Reversing the upward trend in CS rates will require collaboration among health-care providers, health departments, health insurers, policymakers, and the public to reduce syphilis among women and to increase early prenatal care access and syphilis screening during pregnancy.

摘要

未经治疗的梅毒感染,尤其是早期梅毒,可能导致死胎、新生儿死亡,或引起婴儿失聪、神经损伤和骨骼畸形等疾病。通过对孕妇感染的早期检测和至少在分娩前 30 天进行治疗,可以预防先天性梅毒。女性原发性和继发性(P&S)梅毒的人群发病率变化通常会导致先天性梅毒的发病率出现类似变化。为了评估先天性梅毒发病率的近期趋势,美国疾病控制与预防中心(CDC)分析了 2003-2008 年期间的全国监测数据。本报告总结了该分析的结果,结果表明,在连续 14 年下降之后,年龄<1 岁婴儿的先天性梅毒发病率增加了 23%,从 2005 年的每 10 万活产儿 8.2 例上升至 2008 年的 10.1 例。这一增长是在 2004 年至 2007 年期间,年龄>或=10 岁的女性中原发性和继发性梅毒发病率上升 38%之后出现的。在 2005-2008 年期间,先天性梅毒发病率的上升主要出现在南部(从每 10 万活产儿 9.6 例上升至 15.7 例)和黑人母亲所生婴儿中(从每 10 万活产儿 26.6 例上升至 34.6 例)。要扭转先天性梅毒发病率上升的趋势,需要卫生保健提供者、卫生部门、卫生保险公司、政策制定者和公众之间的合作,以减少女性中的梅毒感染,并增加产前保健的早期获得机会和妊娠期间的梅毒筛查。

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