与新生儿先天性梅毒体征相关的因素。
Factors associated with signs of congenital syphilis in newborns.
机构信息
Universidade de Fortaleza (UNIFOR), Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brazil.
Harvard University, Chan School of Public Health, Department of Global Health and Population, Harvard T.H., Boston, MA, United States.
出版信息
J Pediatr (Rio J). 2024 Nov-Dec;100(6):667-673. doi: 10.1016/j.jped.2024.06.008. Epub 2024 Jul 29.
OBJECTIVE
To analyze risk factors (maternal, obstetric and demographic) associated with congenital syphilis and the clinical characteristics of the newborns.
METHOD
A cross-sectional study carried out in ten public maternity hospitals in Fortaleza, Ceará, Brazil that included cases of live births reported with congenital syphilis in 2015.
RESULTS
469 cases were analyzed; 199 (42.4 %) showed some sign or symptom suggestive of congenital syphilis; of these, 65 (32.7 %) were preterm, 87 (43.7 %) had low birth weight, 116 (58.3 %) had jaundice that required phototherapy, 13 (6.5 %) had hepatomegaly, 10 (5 %) had skin lesions, eight (4.0 %) had splenomegaly and one (0.5 %) had limb pseudoparalysis. Records of other clinical changes were identified in 36 (7.7 %) children. Children whose mothers were not treated or who received a drug other than penicillin and those whose mothers had a VDRL titer ≥ 1:16 at birth were 3.7 and 3.2 times more likely to be born with signs of congenital syphilis (p < 0.001- 95 % CI 2.41-5.58; p < 0.001 - 95 % CI 2.41-5.58) respectively.
CONCLUSIONS
The findings of this study draw attention to the importance of improving the quality of prenatal care and the development of studies aimed at finding alternative drugs for the treatment of syphilis in pregnant women and the prevention of congenital syphilis.
目的
分析与先天性梅毒相关的风险因素（母体、产科和人口统计学）以及新生儿的临床特征。
方法
这是一项在巴西塞阿拉州福塔莱萨的 10 家公立妇产医院进行的横断面研究，纳入了 2015 年报告的先天性梅毒活产病例。
结果
共分析了 469 例病例；其中 199 例（42.4%）出现了一些疑似先天性梅毒的体征或症状；其中，65 例（32.7%）早产，87 例（43.7%）出生体重低，116 例（58.3%）有需要光疗的黄疸，13 例（6.5%）肝肿大，10 例（5%）皮肤损伤，8 例（4.0%）脾肿大，1 例（0.5%）肢体假性瘫痪。还发现 36 例（7.7%）儿童有其他临床变化的记录。未接受治疗或接受非青霉素药物治疗的母亲所生的儿童，以及母亲在出生时 VDRL 滴度≥1:16 的儿童，发生先天性梅毒体征的可能性分别是其他母亲所生儿童的 3.7 倍和 3.2 倍（p<0.001-95%CI 2.41-5.58；p<0.001-95%CI 2.41-5.58）。
结论
本研究结果提示，需要提高产前保健质量，并开展研究，寻找替代梅毒孕妇治疗药物和预防先天性梅毒的方法。
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