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孕期梅毒感染筛查:美国预防服务工作组重申建议声明。

Screening for Syphilis Infection During Pregnancy: US Preventive Services Task Force Reaffirmation Recommendation Statement.

作者信息

Silverstein Michael, Wong John B, Davis Esa M, Chelmow David, Coker Tumaini Rucker, Fernandez Alicia, Gibson Ericka, Jaén Carlos Roberto, Krousel-Wood Marie, Lee Sei, Nicholson Wanda K, Rao Goutham, Ruiz John M, Stevermer James, Tsevat Joel, Underwood Sandra Millon, Wiehe Sarah

机构信息

Brown University, Providence, Rhode Island.

Tufts University School of Medicine, Boston, Massachusetts.

出版信息

JAMA. 2025 Jun 10;333(22):2006-2012. doi: 10.1001/jama.2025.5009.

Abstract

IMPORTANCE

Untreated syphilis infection during pregnancy can be passed to the fetus, causing congenital syphilis. Congenital syphilis is associated with premature birth, low birth weight, stillbirth, neonatal death, and significant abnormalities in the infant such as deformed bones, anemia, enlarged liver and spleen, jaundice, brain and nerve problems (eg, permanent vision or hearing loss), and meningitis. In 2023, there were 3882 cases of congenital syphilis in the US, including 279 congenital syphilis-related stillbirths and neonatal/infant deaths, the highest number reported in more than 30 years.

OBJECTIVE

The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update focused on the benefits and harms of screening for syphilis infection in pregnancy.

POPULATION

Adolescents and adults who are pregnant.

EVIDENCE ASSESSMENT

The USPSTF concludes with high certainty that screening for syphilis infection in pregnancy has a substantial net benefit.

RECOMMENDATION

The USPSTF recommends early, universal screening for syphilis infection during pregnancy; if an individual is not screened early in pregnancy, the USPSTF recommends screening at the first available opportunity. (A recommendation).

摘要

重要性

孕期未经治疗的梅毒感染可传染给胎儿,导致先天性梅毒。先天性梅毒与早产、低出生体重、死产、新生儿死亡以及婴儿的严重异常有关,如骨骼畸形、贫血、肝脾肿大、黄疸、脑和神经问题(如永久性视力或听力丧失)以及脑膜炎。2023年,美国有3882例先天性梅毒病例,包括279例与先天性梅毒相关的死产和新生儿/婴儿死亡,这是30多年来报告的最高数字。

目的

美国预防服务工作组(USPSTF)委托进行了一次重新确认的证据更新,重点关注孕期梅毒感染筛查的益处和危害。

人群

怀孕的青少年和成年人。

证据评估

USPSTF非常确定地得出结论,孕期梅毒感染筛查有很大的净益处。

建议

USPSTF建议在孕期对梅毒感染进行早期、普遍筛查;如果个体在孕期早期未接受筛查,USPSTF建议在第一个可获得的机会进行筛查。(A级推荐)

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