Coles F B, Hipp S S, Silberstein G S, Chen J H
Bureau of Sexually Transmitted Disease Control, New York State Department of Health, Albany, NY 12237.
J Infect Dis. 1995 Mar;171(3):732-5. doi: 10.1093/infdis/171.3.732.
Descriptive characteristics and clinical information from 322 cases of congenital syphilis were reviewed. The births (318 mothers) included 31 (10%) stillborn and 59 (18%) with clinical evidence of congenital syphilis. Only 60 (19%) had a complete laboratory workup, including radiographs of long bones and spinal fluid analysis. For a subset of 244 women with available information, 218 (89%) had > or = 1 risk factors for syphilis; however, residence in an area with high morbidity from syphilis was the only identified risk factor for 83 (34%). Eighty women (25%) were treated for syphilis during pregnancy; only 24 were treated appropriately for their stage of syphilis > 30 days before delivery. Five of these pregnancies resulted in infants with clinical signs of syphilis. These findings emphasize the need for expanded prenatal screening of high-risk women, the necessity of screening at delivery, and the need for complete evaluation of infants at risk for congenital syphilis. Further, the data suggest that in some cases therapy in the last trimester of pregnancy may be insufficient to adequately treat the fetus.
回顾了322例先天性梅毒病例的描述性特征和临床信息。这些新生儿（318位母亲）中，有31例（10%）为死产，59例（18%）有先天性梅毒的临床证据。只有60例（19%）进行了完整的实验室检查，包括长骨X线片和脑脊液分析。对于有可用信息的244名女性的一个子集，218例（89%）有≥1个梅毒危险因素；然而，居住在梅毒高发病率地区是83例（34%）唯一确定的危险因素。80名女性（25%）在孕期接受了梅毒治疗；只有24例在分娩前>30天根据其梅毒分期接受了适当治疗。这些妊娠中有5例导致婴儿出现梅毒临床症状。这些发现强调了扩大对高危女性的产前筛查的必要性、分娩时筛查的必要性以及对先天性梅毒高危婴儿进行全面评估的必要性。此外，数据表明在某些情况下，妊娠晚期的治疗可能不足以充分治疗胎儿。
