Kotas Katherine S, Stahlman Shauna L, Ying Saixia, Yun David H, McCannon Charles E, Ambrose John F
Defense Centers for Public Health-Aberdeen, Armed Forces Health Surveillance Division, Defense Health Agency, U.S. Department of Defense, Aberdeen, MD.
Epidemiology and Analysis Branch, Armed Forces Health Surveillance Division, Defense Health Agency, U.S. Department of Defense, Silver Spring, MD.
MSMR. 2024 Dec 20;31(12):12-16.
This report presents the rates of maternal syphilis among pregnant women and congenital syphilis among newborns in the Military Health System (MHS) beneficiary population from 2012 to 2022. Medical encounter data from military hospitals and clinics as well as civilian health care facilities were obtained from the Defense Medical Surveillance System (DMSS) to determine pregnancies, live births, and confirmed diagnoses of maternal and congenital syphilis. The rate of maternal syphilis in female MHS beneficiaries increased by 233% between 2012 (n=123, 66.0 per 100,000 births) and 2022 (n=169, 219.8 per 100,000 births), while the rate of congenital syphilis in newborn MHS beneficiaries increased by 355% (n=9 to n=32, 6.8 to 30.8 per 100,000 live births). Pregnant active component service members generally evinced higher rates of maternal syphilis than pregnant non-service member MHS beneficiaries during the reporting period. Additionally, the positive predictive value of maternal syphilis cases in the MHS was found to be low (59%). Future studies could focus on potential misclassification of maternal syphilis cases as well as syphilis screening compliance and treatment during pregnancy for all pregnant MHS beneficiaries. The rate of diagnosed maternal syphilis among pregnant female active component service members exceeded previously reported rates of syphilis among all female active component service members annually between 2015 and 2022, likely due to increased screening.
本报告展示了2012年至2022年军事卫生系统（MHS）受益人群中孕妇梅毒发病率以及新生儿先天性梅毒发病率。从国防医疗监测系统（DMSS）获取了军事医院和诊所以及民用医疗保健机构的医疗就诊数据，以确定怀孕情况、活产情况以及确诊的孕产妇和先天性梅毒病例。2012年（n = 123，每10万例出生中有66.0例）至2022年（n = 169，每10万例出生中有219.8例）期间，女性MHS受益人群中孕产妇梅毒发病率增长了233%，而新生儿MHS受益人群中先天性梅毒发病率增长了355%（从n = 9增至n = 32，每10万例活产中从6.8例增至30.8例）。在报告期内，现役孕妇军人的孕产妇梅毒发病率普遍高于非军人MHS受益孕妇。此外，发现MHS中孕产妇梅毒病例的阳性预测值较低（59%）。未来的研究可聚焦于孕产妇梅毒病例可能的错误分类以及所有MHS受益孕妇孕期梅毒筛查的依从性和治疗情况。2015年至2022年期间，现役孕妇女性军人中确诊的孕产妇梅毒发病率超过了此前每年报告的所有现役女性军人中的梅毒发病率，这可能是由于筛查增加所致。
