Chen Han-Yang, Klausner Jeffrey D, Stafford Irene A
Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas; and the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California.
Obstet Gynecol. 2024 Aug 1;144(2):207-214. doi: 10.1097/AOG.0000000000005642. Epub 2024 Jun 13.
To examine temporal trends and risk factors for congenital syphilis in newborn hospitalizations and to evaluate the association between adverse outcomes and congenital syphilis and health care utilization for newborn hospitalizations complicated by congenital syphilis.
We conducted a retrospective, cross-sectional study using data from the National Inpatient Sample to identify newborn hospitalizations in the United States between 2016 and 2020. Newborns with congenital syphilis were identified with International Classification of Diseases, Tenth Revision, Clinical Modification codes. Adverse outcomes, hospital length of stay, and hospital costs were examined. The annual percent change was calculated to assess congenital syphilis trend. A multivariable Poisson regression model with robust error variance was used to examine the association between congenital syphilis and adverse outcomes. Adjusted relative risks (RRs) with 95% CIs were calculated. A multivariable generalized linear regression model was used to examine the association between congenital syphilis and hospital length of stay and hospital costs. Adjusted mean ratios with 95% CIs were calculated.
Of 18,119,871 newborn hospitalizations in the United States between 2016 and 2020, the rate of congenital syphilis increased over time (annual percent change 24.6%, 95% CI, 13.0-37.3). Newborn race and ethnicity, insurance, household income, year of admission, and hospital characteristics were associated with congenital syphilis. In multivariable models, congenital syphilis was associated with preterm birth before 37 weeks of gestation (adjusted RR 2.22, 95% CI, 2.02-2.44) and preterm birth before 34 weeks of gestation (adjusted RR 2.39, 95% CI, 2.01-2.84); however, there was no association with low birth weight or neonatal in-hospital death. Compared with newborns without congenital syphilis, hospital length of stay (adjusted mean ratio 3.53, 95% CI, 3.38-3.68) and hospital costs (adjusted mean ratio 4.93, 95% CI, 4.57-5.32) were higher among those with congenital syphilis.
Among newborn hospitalizations in the United States, the rate of congenital syphilis increased from 2016 to 2020. Congenital syphilis was associated with preterm birth, longer hospital length of stay, and higher hospital costs.
研究新生儿住院先天性梅毒的时间趋势和危险因素，并评估不良结局与先天性梅毒之间的关联，以及先天性梅毒所致新生儿住院的医疗保健利用情况。
我们利用全国住院患者样本数据进行了一项回顾性横断面研究，以确定2016年至2020年美国的新生儿住院情况。先天性梅毒新生儿通过国际疾病分类第十版临床修订本编码进行识别。对不良结局、住院时间和住院费用进行了研究。计算年度百分比变化以评估先天性梅毒趋势。使用具有稳健误差方差的多变量泊松回归模型来研究先天性梅毒与不良结局之间的关联。计算调整后的相对风险（RR）及95%置信区间（CI）。使用多变量广义线性回归模型来研究先天性梅毒与住院时间和住院费用之间的关联。计算调整后的平均比率及95%CI。
在2016年至2020年美国的18119871例新生儿住院病例中，先天性梅毒的发生率随时间增加（年度百分比变化24.6%，95%CI为13.0 - 37.3）。新生儿的种族和族裔、保险、家庭收入、入院年份和医院特征与先天性梅毒有关。在多变量模型中，先天性梅毒与妊娠37周前早产（调整后RR 2.22，95%CI为2.02 - 2.44）和妊娠34周前早产（调整后RR 2.39，95%CI为2.01 - 2.84）相关；然而，与低出生体重或新生儿院内死亡无关。与无先天性梅毒的新生儿相比，先天性梅毒患儿的住院时间（调整后平均比率3.53，95%CI为3.38 - 3.68）和住院费用（调整后平均比率4.93，95%CI为4.57 - 5.32）更高。
在美国的新生儿住院病例中，2016年至2020年先天性梅毒的发生率有所增加。先天性梅毒与早产、更长的住院时间和更高的住院费用相关。
