Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Sex Transm Dis. 2013 Feb;40(2):85-94. doi: 10.1097/OLQ.0b013e31827bd688.
The aim of this study was to investigate clinical features and outcomes of children treated for congenital syphilis (CS).
Infants born alive in the public sector of São Lucas Hospital, Porto Alegre, Brazil, 1997 to 2004, whose mothers had syphilis and neonates with CS born in other facilities and admitted during this period were included. Follow-up was performed from birth up to 5 years.
Among 24,920 live births, 379 (1.5%) met the criteria for CS. A further 19 infants born in other hospitals were included, for a total of 398 with CS. We compared infants with CS with 120 infants whose mothers received adequate treatment of syphilis before delivery (total sample, 518 infants). Congenital syphilis was associated with delivery before 34 weeks, low birth weight, and small for gestational age. During the study period, 37 stillbirths with CS were detected. Result from the serum venereal disease research laboratory test was negative at birth in 17.5% of the neonates with CS, and in 4 infants, it became positive after the second day. Thirty percent of the infants with CS were reevaluated between 8 and 60 months, and most had a good outcome when managed according to standard guidelines. Sixteen infants (13.3%) had sequelae. Of these, 8 were symptomatic in the neonatal period, and 13 (81%) of 16 had laboratory/x-ray findings. All asymptomatic and 78% of symptomatic infants had nonreactive fluorescent treponemal antibody absorption test after 12 months of age.
Congenital syphilis remains an impacting disease that causes fetal and neonatal deaths, prematurity, low birth weight, and severe and irreversible sequelae in some children. This study confirms the value of standard guidelines for its management.
本研究旨在探讨先天性梅毒（CS）患儿的临床特征和结局。
纳入 1997 年至 2004 年在巴西阿雷格里港圣卢卡斯医院出生的、母亲患有梅毒且出生时患有 CS 的活产婴儿，以及在此期间在其他机构出生并入院的 CS 新生儿。随访从出生到 5 岁。
在 24920 例活产婴儿中，有 379 例（1.5%）符合 CS 标准。另有 19 例在其他医院出生的婴儿被纳入，共 398 例 CS 患儿。我们将 CS 患儿与 120 例母亲在分娩前接受适当梅毒治疗的婴儿（总样本 518 例）进行比较。CS 患儿与 CS 相关的特征包括：分娩前 34 周，低出生体重和小于胎龄儿。在研究期间，检测到 37 例 CS 死胎。CS 新生儿中，17.5%的新生儿在出生时血清性病研究实验室检测结果为阴性，其中 4 例在出生后第 2 天转为阳性。30%的 CS 患儿在 8 至 60 个月时接受了重新评估，大多数患儿按照标准指南管理后预后良好。16 例（13.3%）患儿出现后遗症。其中，8 例在新生儿期有症状，16 例中有 13 例（81%）实验室/射线检查结果异常。所有无症状和 78%的有症状婴儿在 12 个月后荧光密螺旋体抗体吸收试验均为阴性。
先天性梅毒仍然是一种严重的疾病，可导致胎儿和新生儿死亡、早产、低出生体重以及一些儿童出现严重且不可逆转的后遗症。本研究证实了标准指南在其管理中的价值。
