MMWR Morb Mortal Wkly Rep. 2023 Jan 20;72(3):63-67. doi: 10.15585/mmwr.mm7203a3.
Despite universal prenatal syphilis screening recommendations and availability of effective antibiotic treatment, syphilis prevalence during pregnancy and the incidence of congenital syphilis have continued to increase in the United States (1,2). Concurrent increases in methamphetamine, injection drug, and heroin use have been described in women with syphilis (3). CDC used data on births that occurred during January 1, 2018-December 31, 2021, from two states (Arizona and Georgia) that participate in the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) to describe the prevalence of substance use among pregnant persons with syphilis by congenital syphilis pregnancy outcome (defined as delivery of a stillborn or live-born infant meeting the surveillance case definition for probable or confirmed congenital syphilis). The prevalence of substance use (e.g., tobacco, alcohol, cannabis, illicit use of opioids, and other illicit, nonprescription substances) in persons with a congenital syphilis pregnancy outcome (48.1%) was nearly double that among those with a noncongenital syphilis pregnancy outcome (24.6%). Persons with a congenital syphilis pregnancy outcome were six times as likely to report illicit use of opioids and four times as likely to report using other illicit, nonprescription substances during pregnancy than were persons with a noncongenital syphilis pregnancy outcome. Approximately one half of persons who used substances during pregnancy and had a congenital syphilis pregnancy outcome had late or no prenatal care. Tailored interventions should address barriers and facilitators to accessing screening and treatment for syphilis among persons who use substances. The need for syphilis screening and treatment should be addressed at any health care encounter during pregnancy, especially among persons who use substances.
尽管普遍建议进行产前梅毒筛查，并提供有效的抗生素治疗，但美国妊娠梅毒的患病率和先天性梅毒的发病率仍在持续上升（1,2）。患有梅毒的妇女同时也存在着甲基苯丙胺、注射毒品和海洛因的使用增加的情况（3）。疾病预防控制中心使用了来自两个州（亚利桑那州和佐治亚州）的数据，这些数据来自于参与监测对孕妇和婴儿的新兴威胁网络（SET-NET）的出生记录，以描述按先天性梅毒妊娠结局（定义为符合可能或确诊先天性梅毒监测病例定义的死产或活产婴儿分娩）划分的患有梅毒的孕妇中物质使用的流行率。患有先天性梅毒妊娠结局的孕妇（48.1%）物质使用（例如，烟草、酒精、大麻、非法使用阿片类药物和其他非法的非处方物质）的流行率几乎是患有非先天性梅毒妊娠结局的孕妇（24.6%）的两倍。患有先天性梅毒妊娠结局的孕妇报告非法使用阿片类药物的可能性是患有非先天性梅毒妊娠结局的孕妇的六倍，报告在怀孕期间使用其他非法非处方物质的可能性是后者的四倍。大约一半在怀孕期间使用物质且患有先天性梅毒妊娠结局的孕妇接受的产前护理较晚或根本没有接受产前护理。应该针对物质使用者接受梅毒筛查和治疗的障碍和促进因素采取有针对性的干预措施。在怀孕期间的任何医疗保健接触中，都应解决梅毒筛查和治疗的需求，尤其是针对物质使用者。
