Nanda D, Feldman J, Delke I, Chintalapally S, Minkoff H
Department of Obstetrics and Gynecology, State University of New York Health Science Center, Brooklyn 11203.
N Y State J Med. 1990 Oct;90(10):488-90.
The frequency of positive cord blood rapid plasma reagin (RPR) tests among newborns at an inner city hospital and associations with maternal cocaine use, prenatal care, and adequacy of syphilis therapy were retrospectively assessed. The incidence of positive cord blood RPRs increased from 1.1% of all live births in 1985 to 3.4% in 1988. In 1987, 98 babies were born with positive cord blood RPRs; 86 of their charts were available for review. Four infants had false positive RPRs, and one patient delivered twins, leaving 81 mothers who could be evaluated. Almost 37% of these patients had had no prenatal care. More than 55% had inadequate or not therapy for syphilis. Of these, only 17.4% had prenatal care. Slightly more than 40% of patients acknowledged using drugs during pregnancy, 87.9% of whom used cocaine. Among the patients who used drugs, 75.8% received no prenatal care, in contrast to 10.4% of mothers who did not use drugs (p less than 0.001). It appears that drug use, particularly use of cocaine, is associated with low levels of utilization of prenatal services and inadequate therapy for syphilis. This may lead to increased risk of congenital syphilis in newborns.
对一家市中心医院新生儿脐带血快速血浆反应素（RPR）检测阳性的频率以及与母亲使用可卡因、产前护理和梅毒治疗充分性之间的关联进行了回顾性评估。脐带血RPR检测阳性的发生率从1985年所有活产婴儿的1.1%上升至1988年的3.4%。1987年，有98名婴儿出生时脐带血RPR检测呈阳性；其中86份病历可供审查。4名婴儿的RPR检测为假阳性，1名患者产下双胞胎，因此有81名母亲可供评估。这些患者中近37%未接受产前护理。超过55%的患者梅毒治疗不足或未接受治疗。其中，只有17.4%的患者接受了产前护理。略多于40%的患者承认在孕期使用过药物，其中87.9%使用过可卡因。在使用药物的患者中，75.8%未接受产前护理，而未使用药物的母亲中这一比例为10.4%（p<0.001）。看来，药物使用，尤其是可卡因的使用，与产前服务利用率低和梅毒治疗不足有关。这可能会增加新生儿先天性梅毒的风险。
