Cha Susan, Malik Tasneem, Abara Winston E, DeSimone Mia S, Schumann Bernadette, Mallada Esther, Klemme Michael, Aguon Vince, Santos Anne Marie, Peterman Thomas A, Bolan Gail, Kamb Mary L
MMWR Morb Mortal Wkly Rep. 2017 Jun 23;66(24):644-648. doi: 10.15585/mmwr.mm6624a4.
Prenatal screening and treatment for sexually transmitted infections (STIs) can prevent adverse perinatal outcomes. In Guam, the largest of the three U.S. territories in the Pacific, primary and secondary syphilis rates among women increased 473%, from 1.1 to 6.3 per 100,000 during 2009-2013 (1). In 2013, the first congenital syphilis case after no cases since 2008 was reported (1,2). Little is known about STI screening coverage and factors associated with inadequate screening among pregnant women in Guam. This study evaluated the prevalence of screening for syphilis, human immunodeficiency virus (HIV), chlamydia, and gonorrhea, and examined correlates of inadequate screening among pregnant women in Guam. Data came from the medical records of a randomly selected sample of mothers with live births in 2014 at a large public hospital. Bivariate analyses and multivariable models using Poisson regression were conducted to determine factors associated with inadequate screening for syphilis and other STIs. Although most (93.5%) women received syphilis screening during pregnancy, 26.8% were not screened sufficiently early to prevent adverse pregnancy outcomes. Many women were not screened for HIV infection (31.1%), chlamydia (25.3%), or gonorrhea (25.7%). Prenatal care and insurance were important factors affecting STI screening during pregnancy. Prenatal care providers play an important role in preventing congenital infections. Policies and programs increasing STI and HIV services for pregnant women and improved access to and use of prenatal care are essential for promoting healthy mothers and infants.
性传播感染（STIs）的产前筛查和治疗可预防不良围产期结局。在关岛（美国太平洋地区三大领地中最大的一个），2009 - 2013年期间，女性原发性和继发性梅毒发病率增长了473%，从每10万人1.1例增至6.3例（1）。2013年，报告了自2008年无病例以来的首例先天性梅毒病例（1,2）。对于关岛孕妇的性传播感染筛查覆盖率以及与筛查不足相关的因素，人们了解甚少。本研究评估了梅毒、人类免疫缺陷病毒（HIV）、衣原体和淋病的筛查患病率，并调查了关岛孕妇筛查不足的相关因素。数据来自2014年在一家大型公立医院随机抽取的有活产婴儿的母亲的病历。进行了双变量分析和使用泊松回归的多变量模型，以确定与梅毒和其他性传播感染筛查不足相关的因素。尽管大多数（93.5%）女性在孕期接受了梅毒筛查，但26.8%的女性筛查时间不够早，无法预防不良妊娠结局。许多女性未接受HIV感染（31.1%）、衣原体（25.3%）或淋病（25.7%）的筛查。产前护理和保险是影响孕期性传播感染筛查的重要因素。产前护理提供者在预防先天性感染方面发挥着重要作用。增加针对孕妇的性传播感染和HIV服务以及改善产前护理的可及性和利用率的政策和项目对于促进母婴健康至关重要。
