Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
Sci Rep. 2020 Jul 21;10(1):12026. doi: 10.1038/s41598-020-69070-3.
This study was aimed to describe the standardized treatment rate of syphilis-infected pregnant women in Hunan province and to explore the determinants for standardized treatment. All syphilis-infected pregnant women registered in the Information System of Prevention of Mother-to-Child Transmission of Syphilis Management (IPMTCT) in Hunan between January 2015 and December 2018 were included in this study. Among 9,059 pregnant women with syphilis, 7,797 received syphilis treatment, with a treatment rate of 86.1%, and 4,963 underwent standardized syphilis treatment, with an average standardized treatment rate of 54.8%. The facilitators for the standardized treatment included abnormal reproductive histories (aOR = 1.15, 95%CI:1.03-1.28), time of first prenatal care within 1-12 weeks (aOR = 5.17, 95%CI:4.19-6.37) or within 13-27 weeks (aOR = 5.56, 95%CI:4.46-6.92), previous syphilis infection (aOR = 1.64, 95%CI: 1.48-1.81), and definite syphilis infection status of sexual partner (negative: aOR = 1.73, 95%CI:1.57-1.91; positive: aOR = 1.62, 95%CI:1.34-1.95). The barriers included marital status being unmarried/divorced/widowed (aOR = 0.81, 95%CI: 0.65-0.99), pluripara (aOR = 0.58, 95%CI: 0.46-0.74), number of children ≥ 2 (aOR = 0.45, 95%CI: 0.35-0.57), and syphilis clinical stage being primary/secondary/tertiary (aOR = 0.72, 95%CI: 0.58-0.88) or unclear (aOR = 0.78, 95%CI: 0.70-0.86). Though the treatment rate of syphilis-infected pregnant women was high, the standardized treatment rate was low. The facilitators and barriers on standardized treatment of gestational syphilis were identified at the patient level.
本研究旨在描述湖南省梅毒感染孕妇的标准化治疗率，并探讨其标准化治疗的决定因素。本研究纳入了 2015 年 1 月至 2018 年 12 月期间在湖南省预防母婴传播梅毒信息管理系统（IPMTCT）中登记的所有梅毒感染孕妇。在 9059 名梅毒感染孕妇中，7797 名接受了梅毒治疗，治疗率为 86.1%，4963 名接受了标准化梅毒治疗，平均标准化治疗率为 54.8%。标准化治疗的促进因素包括异常生殖史（aOR=1.15，95%CI：1.03-1.28）、首次产前检查时间在 1-12 周（aOR=5.17，95%CI：4.19-6.37）或 13-27 周（aOR=5.56，95%CI：4.46-6.92）、既往梅毒感染（aOR=1.64，95%CI：1.48-1.81）和性伴侣明确的梅毒感染状态（阴性：aOR=1.73，95%CI：1.57-1.91；阳性：aOR=1.62，95%CI：1.34-1.95）。障碍因素包括未婚/离婚/丧偶（aOR=0.81，95%CI：0.65-0.99）、多产妇（aOR=0.58，95%CI：0.46-0.74）、子女数≥2（aOR=0.45，95%CI：0.35-0.57）和梅毒临床分期为一期/二期/三期（aOR=0.72，95%CI：0.58-0.88）或不明（aOR=0.78，95%CI：0.70-0.86）。尽管梅毒感染孕妇的治疗率较高，但标准化治疗率较低。在患者层面确定了妊娠梅毒标准化治疗的促进因素和障碍因素。
