Kulsirichawaroj Pimchanok, Lumbiganon Dissajee
Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok 10330, Thailand.
Division of Neonatology, Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10330, Thailand.
Asian Biomed (Res Rev News). 2023 Aug 7;17(1):13-21. doi: 10.2478/abm-2023-0039. eCollection 2023 Feb.
The incidence of congenital syphilis is increasing worldwide, in parallel with the increase of syphilis in the general population.
This study aimed to determine the incidence and risk factors for congenital syphilis at a referral tertiary care center in Bangkok, Thailand.
This is a case-control study using the hospital medical records of neonates born at our hospital, whose mothers had confirmed syphilis during pregnancy or at delivery between 2011 and 2018. Maternal and neonatal data were reviewed. Neonates were categorized into congenital syphilis according to CDC surveillance case definition for congenital syphilis 2015 and the American Academy of Pediatrics Congenital Syphilis 2018: confirmed and probable were assigned to the case group, while possible and less likely congenital syphilis were used as the control group. Factors associated with congenital syphilis were analyzed using univariable and multivariable analysis.
Among 19,558 live births, there were 126 neonates born to mothers with syphilis. Almost 40% of mothers were teenage mothers and 48.4% had inadequate or no syphilis treatment. Forty neonates met the criteria of congenital syphilis giving the incidence of 204 per 100,000 live births (95% confidence interval [CI]: 146-278). Factors associated with congenital syphilis were inadequate treatment of maternal syphilis and preterm birth (adjusted odd ratio [aOR]: 2.69, 95% CI: 1.02-7.11, = 0.046 and aOR: 2.91; 95% CI: 1.01-8.39, = 0.049, respectively).
The incidence of congenital syphilis in our institution was high. Factors associated with congenital syphilis were inadequate treatment of maternal syphilis and preterm birth. Improvement of prenatal care should be emphasized.
全球先天性梅毒的发病率在上升，与普通人群中梅毒发病率的增加同步。
本研究旨在确定泰国曼谷一家三级转诊医疗中心先天性梅毒的发病率及危险因素。
这是一项病例对照研究，使用了我院出生的新生儿的医院病历，这些新生儿的母亲在2011年至2018年期间怀孕或分娩时确诊患有梅毒。对母婴数据进行了回顾。根据2015年美国疾病控制与预防中心（CDC）先天性梅毒监测病例定义和2018年美国儿科学会先天性梅毒定义，将新生儿分为先天性梅毒组：确诊和疑似病例归入病例组，而可能和不太可能患先天性梅毒的新生儿作为对照组。使用单变量和多变量分析方法分析与先天性梅毒相关的因素。
在19558例活产中，有126例新生儿的母亲患有梅毒。近40%的母亲为青少年母亲，48.4%的母亲梅毒治疗不充分或未接受治疗。40例新生儿符合先天性梅毒标准，发病率为每10万活产204例（95%置信区间[CI]：146 - 278）。与先天性梅毒相关的因素是母亲梅毒治疗不充分和早产（校正比值比[aOR]：2.69，95%CI：1.02 - 7.11，P = 0.046；aOR：2.91；95%CI：1.01 - 8.39，P = 0.049）。
我院先天性梅毒的发病率较高。与先天性梅毒相关的因素是母亲梅毒治疗不充分和早产。应强调改善产前护理。
