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[上海梅毒感染孕产妇所生儿童的健康状况及医疗服务利用情况]

[Health status and healthcare service utilization among children born to women with maternal syphilis in Shanghai].

作者信息

Li Y, Li B Y, Gu Y B, Du L, Jiang W L, Zhu L P, Xu B

机构信息

Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; Key Lab of Health Technology Assessment, National Health Commission, Fudan University Shanghai 200032, China.

Department of Science and Education, Shanghai Center for Women and Children's Health, Shanghai 200062, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Mar 10;41(3):337-342. doi: 10.3760/cma.j.issn.0254-6450.2020.03.011.

Abstract

To assess the health status and health service utilization of children born to syphilis infected mothers during pregnancy, in order to prevent mother-to-child transmission of syphilis to the newborns. Women with maternal syphilis were studied by trained researchers via phone calls, in Shanghai during 2014-2015. Data related to demographics, status of infection and health care, utilization by both mothers and their children were collected through specifically designed questionnaires. Non-parametric tests including chi-square were used to assess the health status and health service utilization of children born to mothers with different demographic and socioeconomic characteristics. A total of 495 children born to mothers with maternal syphilis were recruited from 1 000 syphilis infected parturient women. A total of 61 out of the 495 children were diagnosed as having congenital syphilis (57 children were diagnosed at birth and another 4 were diagnosed during the follow-up period). Children born to women who received syphilis treatment during pregnancy were at lower risk on congenital syphilis ((2)=7.214, =0.027). 37.8 of the children were reported to have had different illnesses in the past three months, mainly involving upper respiratory infections (32.3) or diarrhea (3.6). Children diagnosed with congenital syphilis showed a higher prevalence of different kinds of diseases, compared to those without congenital syphilis (47.5 36.6). 81.6 of the children had received regular child health care services. Subjects with the following factors as: being immigrant, with lower education, unemployed, unmarried and multipara, were related to the less use of regular child healthcare services. Only 39.7 of the parents would inform the care-takers about the risk of congenital syphilis infection of their own children at the child health care centers. Mothers with residency of Shanghai, having higher education level and employed, were less willing to inform doctors about the risk of congenital syphilis infection of their children. Loss to follow-up among children born to syphilis infected pregnant women remained a serious problem. Few parents would be willing to inform the healthcare takers that their children are at risk of syphilis, when receiving child health care services at the centers. It was necessary to integrate the congenital syphilis follow-up programs into the routine child care services so as to timely diagnose and treat the patients with congenital syphilis.

摘要

为评估孕期感染梅毒母亲所生儿童的健康状况及医疗服务利用情况,以预防梅毒母婴传播给新生儿。2014年至2015年期间,在上海,经过培训的研究人员通过电话对患有梅毒的母亲进行了研究。通过专门设计的问卷收集了与人口统计学、感染状况及医疗保健、母亲及其子女的医疗服务利用情况相关的数据。使用包括卡方检验在内的非参数检验来评估不同人口统计学和社会经济特征母亲所生儿童的健康状况及医疗服务利用情况。从1000名感染梅毒的产妇中招募了495名感染梅毒母亲所生的儿童。495名儿童中共有61名被诊断为先天性梅毒(57名儿童在出生时被诊断,另外4名在随访期间被诊断)。孕期接受梅毒治疗的妇女所生儿童患先天性梅毒的风险较低(χ² = 7.214,P = 0.027)。据报告,37.8%的儿童在过去三个月患有不同疾病,主要为上呼吸道感染(32.3%)或腹泻(3.6%)。与未患先天性梅毒的儿童相比,被诊断为先天性梅毒的儿童各类疾病患病率更高(47.5%对36.6%)。81.6%的儿童接受了定期儿童保健服务。具有以下因素的受试者,如移民、教育程度较低、失业、未婚和多产妇,与较少使用定期儿童保健服务有关。只有39.7%的家长在儿童保健中心会告知护理人员其子女先天性梅毒感染的风险。具有上海户籍、教育程度较高且就业的母亲不太愿意告知医生其子女先天性梅毒感染的风险。梅毒感染孕妇所生儿童失访仍是一个严重问题。在儿童保健中心接受服务时,很少有家长会愿意告知医护人员其子女有梅毒感染风险。有必要将先天性梅毒随访项目纳入常规儿童保健服务,以便及时诊断和治疗先天性梅毒患者。

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