McFarlin B L, Bottoms S F
West Virginia Hospital, Morgantown, USA.
Am J Perinatol. 1996 Nov;13(8):513-8. doi: 10.1055/s-2007-994439.
We sought to determine: (1) the perinatal outcomes in the subsequent pregnancy; (2) the natural history of serologic titers over the course of the two pregnancies; and (3) the incidence and risk factors for delivering an infant with congenital syphilis in the subsequent pregnancy. Over a five-year period, we reviewed the charts of 46 women with maternal syphilis during pregnancy who had a subsequent pregnancy and delivered in our institution. The initial and subsequent pregnancy outcomes were contrasted. To characterize the subsequent pregnancy risk of congenital syphilis, those women with recurrent congenital syphilis were contrasted to women who delivered infants without congenital syphilis. Rapid plasma reagin (RPR) titers in the initial and subsequent pregnancy were analyzed by neonatal outcome. Forty percent of the women who delivered an infant with congenital syphilis in their first pregnancy delivered yet another infant with congenital syphilis in the subsequent pregnancy. Continued cocaine use was the single most important risk factor for delivering another infant with congenital syphilis (p < 0.0001). Forty-two percent of the women who delivered an infant without congenital syphilis in the initial pregnancy delivered an infant with congenital syphilis in the subsequent pregnancy. Birthweight, the number of neonatal hospital days, and the incidence of respiratory distress syndrome (RDS), neonatal pneumonia, abruption, and positive meconium drug screens were not significantly different between the initial and subsequent pregnancies. As with the initial pregnancy, women continued to experience poor pregnancy outcomes in the subsequent pregnancy.
(1) 后续妊娠的围产期结局；(2) 两次妊娠期间血清学滴度的自然变化过程；以及 (3) 后续妊娠中分娩先天性梅毒婴儿的发生率和危险因素。在五年期间，我们回顾了我院46例孕期患有梅毒且随后再次妊娠并分娩的女性的病历。对比了首次和后续妊娠的结局。为了描述后续妊娠先天性梅毒的风险，将那些复发先天性梅毒的女性与分娩无先天性梅毒婴儿的女性进行了对比。根据新生儿结局分析首次和后续妊娠中的快速血浆反应素（RPR）滴度。首次妊娠中分娩先天性梅毒婴儿的女性，有40%在后续妊娠中又分娩了一名先天性梅毒婴儿。持续使用可卡因是再次分娩先天性梅毒婴儿的唯一最重要的危险因素（p<0.0001）。首次妊娠中分娩无先天性梅毒婴儿的女性，有42%在后续妊娠中分娩了先天性梅毒婴儿。首次和后续妊娠之间的出生体重、新生儿住院天数、呼吸窘迫综合征（RDS）、新生儿肺炎、胎盘早剥和胎粪药物筛查阳性的发生率没有显著差异。与首次妊娠一样，女性在后续妊娠中仍然经历不良的妊娠结局。
