Fanella Sergio, Bitnun Ari, Barton Michelle, Sauvé Laura
Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario, Canada.
Paediatr Child Health. 2024 Dec 12;29(7):463-479. doi: 10.1093/pch/pxae044. eCollection 2024 Nov.
Congenital syphilis can result in pregnancy loss and substantial morbidity in newborns. The current epidemic of congenital syphilis in Canada (especially Western Canada) is a preventable public health emergency. Rates indicate a lack of control of syphilis within the community and insufficient public health resources to prevent spread that predate the COVID-19 pandemic. Risk factors include lack of prenatal care, methamphetamine and other substance use, and unstable housing. The cornerstone of prevention is identification, treatment, and follow-up during pregnancy, including of partners. Clinicians caring for newborns need to consider aspects of maternal treatment, reinfection risk, the results of paired maternal and infant syphilis serology, and infant clinical assessment. A complete risk assessment will guide effective management and follow-up of infants exposed in utero to syphilis.
先天性梅毒可导致流产以及新生儿出现严重发病情况。加拿大（尤其是加拿大西部）目前的先天性梅毒流行是一场可预防的公共卫生突发事件。发病率表明社区内梅毒防控不力，且在新冠疫情之前就已存在预防传播的公共卫生资源不足的情况。风险因素包括缺乏产前护理、使用甲基苯丙胺及其他药物，以及住房不稳定。预防的基石是孕期的识别、治疗及随访，包括对性伴侣的处理。照顾新生儿的临床医生需要考虑母体治疗情况、再感染风险、母婴梅毒血清学配对结果以及婴儿临床评估。全面的风险评估将指导对子宫内暴露于梅毒的婴儿进行有效的管理和随访。
