南朗医院流动孕妇人群梅毒血清流行病学研究
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摘要
目的调查南朗医院流动孕妇人群梅毒感染情况,为降低妊娠梅毒发生率提供科学依据。方法选取2011年6月~2015年6月在中山市南朗医院性病专科门诊和皮肤性病专科门诊就诊以及进行免费性病检查的孕妇8034例为研究对象,收集该类人群的一般资料并进行统计分析,确定孕妇的感染率以及孕妇感染梅毒的影响因素。结果感染梅毒患者96例,比例为1.19%,其中二产及以上产次的孕妇感染率(1.69%)显著高于一产孕妇(0.98%)。96例感染梅毒的孕妇共生产98例新生儿,早产2例,死亡1例,畸形1例。单因素分析显示,年龄、职业、文化程度、个人经济收入、户籍情况、婚姻情况、配偶是否患有梅毒7个因素均为孕妇感染梅毒的相关影响因素(P<0.05)。Logistic回归分析结果显示,职业、文化程度、个人经济收入、户籍情况、婚姻情况、配偶是否患有梅毒6个因素为孕妇感染梅毒的独立影响因素(P<0.05)。结论为了降低妊娠梅毒发生率,主动参加婚前检查或者将梅毒非特异性的初筛实验作为产前常规检查是十分必要的,预防的重点人群为低学历、低收入、配偶感染梅毒、流动的从事服务性职业的妇女。
Objective To investigate the syphilis infection status of pregnant women among floating population in Nanlang Hospital, in order to provide scientific basis for reducing pregnancy syphilis incidence. Methods 8034 cases of pregnant women treated in Venereal Disease Specialist Out-patient and taken free venereal disease inspection in Nanlang Hospital of Zhongshan City from June 2011 to June 2015 were selected as research objects. General information of the population were collected and analyzed. The infection rate among pregnant women and factors influced the pregnant women infected with syphilis were confirmed. Results 96 cases of pregnant women were comfirmed syphilis infection,the proportion was 1.19%, of whom the infection rate of pregnant women with twice and more pregnancies and labors(1.69%) was significantly higher than pregnant women with first pregnancies and labors(0.98%). 96 cases of pregnant women with syphilis infection had born 98 cases of newborns, 2 cases had premature birth, 1 case had dead, 1 cases had deformity. Single factor analysis showed that age, occupation, educational level, personal income, household, marriage, spouse suffering from syphilis or not were influencing factors of syphilis infection in pregnant women(P < 0.05).Logistic regression analysis showed that, occupation, education level, personal income, household, marriage, spouse suffering from syphilis or not were independent risk factors of syphilis infection in pregnant women(P < 0.05). Conclusion In order to reduce pregnancy syphilis incidence, take the initiative to participating in premarital examination or non-specific syphilis screening test as a routine prenatal examination is very necessary. Low education, low income, spouse suffering from syphilis, flowing pregnancy taking career in the service are the preventive focus groups.
Objective To investigate the syphilis infection status of pregnant women among floating population in Nanlang Hospital, in order to provide scientific basis for reducing pregnancy syphilis incidence. Methods 8034 cases of pregnant women treated in Venereal Disease Specialist Out-patient and taken free venereal disease inspection in Nanlang Hospital of Zhongshan City from June 2011 to June 2015 were selected as research objects. General information of the population were collected and analyzed. The infection rate among pregnant women and factors influced the pregnant women infected with syphilis were confirmed. Results 96 cases of pregnant women were comfirmed syphilis infection,the proportion was 1.19%, of whom the infection rate of pregnant women with twice and more pregnancies and labors(1.69%) was significantly higher than pregnant women with first pregnancies and labors(0.98%). 96 cases of pregnant women with syphilis infection had born 98 cases of newborns, 2 cases had premature birth, 1 case had dead, 1 cases had deformity. Single factor analysis showed that age, occupation, educational level, personal income, household, marriage, spouse suffering from syphilis or not were influencing factors of syphilis infection in pregnant women(P < 0.05).Logistic regression analysis showed that, occupation, education level, personal income, household, marriage, spouse suffering from syphilis or not were independent risk factors of syphilis infection in pregnant women(P < 0.05). Conclusion In order to reduce pregnancy syphilis incidence, take the initiative to participating in premarital examination or non-specific syphilis screening test as a routine prenatal examination is very necessary. Low education, low income, spouse suffering from syphilis, flowing pregnancy taking career in the service are the preventive focus groups.
引文
[1]索庆丽,胡晞江,胡睿,等.武汉市41709例孕产妇梅毒感染状况的调查分析[J].重庆医学,2013,42(1):57-58,110.
[2]王华,张洪为,雷丽明,等.胎传梅毒152例临床流行病学调查分析[J].中国皮肤性病学杂志,2013,27(1):52-53,90.
[3]Qin JB,Feng TJ,Yang TB,et al.Risk factors for congenital syphilis and adverse pregnancy outcomes in offspring of women with syphilis in Shenzhen,China:a prospective nested case-control study[J].Sex Transm Dis,2014,41(1):13-23.
[4]Newman L,Kamb M,Hawkes S,et al.Global estimates of syphilis in pregnancy and associated adverse outcomes:analysis of multinational antenatal surveillance data[J].PLo S Med,2013,10(2):e1001396.
[5]潘鹏,蔡于茂,洪福昌,等.流行病学治疗在梅毒孕妇配偶人群中的初步应用[J].皮肤性病诊疗学杂志,2012,19(3):182-185.
[6]邱莉霞,胡瑞娟,许宗严,等.深圳市福田区2005-2011年妊娠梅毒患者流行病学分析[J].实用预防医学,2012,19(8):1215-1217.
[7]李永双,张志云,张晓丽,等.深圳市光明新区孕妇及新生儿梅毒感染状况分析[J].现代预防医学,2013,40(9):1638-1640,1643.
[8]Gomez GB,Kamb ML,Newman LM,et al.Untreated maternal syphilis and adverse outcomes of pregnancy:a systematic review and meta-analysis[J].Bull World Health Organ,2013,91(3):217-226.
[9]潘开国,黄宇.152例胎传梅毒的临床流行病学分析[J].中国当代医药,2014,21(1):158-159,162.
[10]李新,谭德友,董巨浪,等.妊娠梅毒的研究进展[J].佛山科学技术学院学报:自然科学版,2012,30(3):82-85.
[11]Lawi JDT,Mirambo MM,Magoma M,et al.Sero-conversion rate of Syphilis and HIV among pregnant women attending antenatal clinic in Tanzania:a need for re-screening at delivery[J].BMC Pregnancy Childbirth,2015,15(1):3.
[12]吴炜英,裘桂静,俞旦旦,等.妊娠期梅毒早期母婴阻断效果分析[J].国际流行病学传染病学杂志,2014,41(2):101-103.
[13]Hawkes SJ,Gomez GB,Broutet N.Early antenatal care:does it make a difference to outcomes of pregnancy associated with syphilis?A systematic review and metaanalysis[J].PLo S One,2013,8(2):e56713.
[14]康湘怡,张海萍.我国妊娠梅毒的现状与诊治[J].中国计划生育学杂志,2013,21(6):427-429.
[15]李新,谭德友,董巨浪,等.佛山地区妊娠梅毒的流行病学特征[J].吉林医学,2014,35(4):799-800.
[16]孙翠玲,张素英.妊娠合并梅毒126例妊娠结局分析[J].国际流行病学传染病学杂志,2014,41(1):41-43.
[17]Hawkes S,Matin N,Broutet N,et al.Effectiveness of interventions to improve screening for syphilis in pregnancy:a systematic review and meta-analysis[J].Lancet Infect Dis,2011,11(9):684-691.
[18]侯存军,李中伟.妊娠梅毒与先天梅毒[J].国际流行病学传染病学杂志,2013,40(2):136-138.
[19]王东芳,丁娟.19360例孕产妇梅毒流行病学分析[J].中国保健营养:上旬刊,2013,23(3):1538-1539.
[20]Blencowe H,Cousens S,Kamb M,et al.Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality[J].BMC Public Health,2011,11(Suppl 3):S9.
[21]黄密芬,顾海娜.晚期妊娠合并潜伏期梅毒对母婴的影响及防治对策[J].中国性科学,2015,24(6):90-93.
[22]肖雪,周燕媚,孙雯,等.2009~2013年妊娠合并梅毒孕妇及围产儿感染因素的调查[J].南方医科大学学报,2014,34(1):144-146.
[23]夏亚娣,方雅琴,孙芸,等.绍兴地区妇科门诊女性就诊者梅毒患病率及危险因素分析[J].中国性科学,2015,24(3):39-42.
[24]Pan X,Zhu Y,Wang Q,et al.Prevalence of HIV,syphilis,HCV and their high risk behaviors among migrant workers in eastern China[J].Plo S One,2013,8(2):e57258.
[2]王华,张洪为,雷丽明,等.胎传梅毒152例临床流行病学调查分析[J].中国皮肤性病学杂志,2013,27(1):52-53,90.
[3]Qin JB,Feng TJ,Yang TB,et al.Risk factors for congenital syphilis and adverse pregnancy outcomes in offspring of women with syphilis in Shenzhen,China:a prospective nested case-control study[J].Sex Transm Dis,2014,41(1):13-23.
[4]Newman L,Kamb M,Hawkes S,et al.Global estimates of syphilis in pregnancy and associated adverse outcomes:analysis of multinational antenatal surveillance data[J].PLo S Med,2013,10(2):e1001396.
[5]潘鹏,蔡于茂,洪福昌,等.流行病学治疗在梅毒孕妇配偶人群中的初步应用[J].皮肤性病诊疗学杂志,2012,19(3):182-185.
[6]邱莉霞,胡瑞娟,许宗严,等.深圳市福田区2005-2011年妊娠梅毒患者流行病学分析[J].实用预防医学,2012,19(8):1215-1217.
[7]李永双,张志云,张晓丽,等.深圳市光明新区孕妇及新生儿梅毒感染状况分析[J].现代预防医学,2013,40(9):1638-1640,1643.
[8]Gomez GB,Kamb ML,Newman LM,et al.Untreated maternal syphilis and adverse outcomes of pregnancy:a systematic review and meta-analysis[J].Bull World Health Organ,2013,91(3):217-226.
[9]潘开国,黄宇.152例胎传梅毒的临床流行病学分析[J].中国当代医药,2014,21(1):158-159,162.
[10]李新,谭德友,董巨浪,等.妊娠梅毒的研究进展[J].佛山科学技术学院学报:自然科学版,2012,30(3):82-85.
[11]Lawi JDT,Mirambo MM,Magoma M,et al.Sero-conversion rate of Syphilis and HIV among pregnant women attending antenatal clinic in Tanzania:a need for re-screening at delivery[J].BMC Pregnancy Childbirth,2015,15(1):3.
[12]吴炜英,裘桂静,俞旦旦,等.妊娠期梅毒早期母婴阻断效果分析[J].国际流行病学传染病学杂志,2014,41(2):101-103.
[13]Hawkes SJ,Gomez GB,Broutet N.Early antenatal care:does it make a difference to outcomes of pregnancy associated with syphilis?A systematic review and metaanalysis[J].PLo S One,2013,8(2):e56713.
[14]康湘怡,张海萍.我国妊娠梅毒的现状与诊治[J].中国计划生育学杂志,2013,21(6):427-429.
[15]李新,谭德友,董巨浪,等.佛山地区妊娠梅毒的流行病学特征[J].吉林医学,2014,35(4):799-800.
[16]孙翠玲,张素英.妊娠合并梅毒126例妊娠结局分析[J].国际流行病学传染病学杂志,2014,41(1):41-43.
[17]Hawkes S,Matin N,Broutet N,et al.Effectiveness of interventions to improve screening for syphilis in pregnancy:a systematic review and meta-analysis[J].Lancet Infect Dis,2011,11(9):684-691.
[18]侯存军,李中伟.妊娠梅毒与先天梅毒[J].国际流行病学传染病学杂志,2013,40(2):136-138.
[19]王东芳,丁娟.19360例孕产妇梅毒流行病学分析[J].中国保健营养:上旬刊,2013,23(3):1538-1539.
[20]Blencowe H,Cousens S,Kamb M,et al.Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality[J].BMC Public Health,2011,11(Suppl 3):S9.
[21]黄密芬,顾海娜.晚期妊娠合并潜伏期梅毒对母婴的影响及防治对策[J].中国性科学,2015,24(6):90-93.
[22]肖雪,周燕媚,孙雯,等.2009~2013年妊娠合并梅毒孕妇及围产儿感染因素的调查[J].南方医科大学学报,2014,34(1):144-146.
[23]夏亚娣,方雅琴,孙芸,等.绍兴地区妇科门诊女性就诊者梅毒患病率及危险因素分析[J].中国性科学,2015,24(3):39-42.
[24]Pan X,Zhu Y,Wang Q,et al.Prevalence of HIV,syphilis,HCV and their high risk behaviors among migrant workers in eastern China[J].Plo S One,2013,8(2):e57258.