Abstract：
BACKGROUND: There are a lack of studies about factors influencing congenital syphilis (CS) in economically underdeveloped areas, such as Jiangxi Province, China.
METHODS: A retrospective study was conducted based on the information system of prevention of mother-to-child transmission of syphilis management in Jiangxi Province, China. Pregnant women with syphilis infection who delivered ≥28 gestational weeks and registered in this system from 1 January 2013 to 2030 June 2018 were enrolled. Maternal characteristics and treatment regimens associated with CS were evaluated using multivariable regression analysis.
RESULTS: 1196 syphilis infected mothers and their 1207 infants were included in the analyses, and 116 infants were diagnosed with CS, providing an overall incidence of 9.61% (116/1207). Multivariable logistic regression analysis showed that increasing maternal age was barely associated with the risk of CS (adjusted odds ratio (aOR) = 0.97, 95% CI, 0.93-1.00, p = .047). Women with a high nontreponemal serum test titer (≥1:8) had a 126% increased risk of delivering an infant with CS than those with a low titer (<1:8) (aOR = 2.26, 95% CI, 1.51-3.39, p < .001). The risk for CS decreased significantly in infants born to mothers receiving adequate treatment than those receiving no treatment (aOR = 0.36, 95% CI, 0.21-0.61, p < .001).
CONCLUSIONS: Adequate treatment is critical for the prevention of CS. Further strategies focusing on early diagnosis and adequate treatment among syphilis infected pregnant women, particularly among those with younger age and high nontreponemal titer, should be strengthened to prevent CS.
METHODS: A retrospective study was conducted based on the information system of prevention of mother-to-child transmission of syphilis management in Jiangxi Province, China. Pregnant women with syphilis infection who delivered ≥28 gestational weeks and registered in this system from 1 January 2013 to 2030 June 2018 were enrolled. Maternal characteristics and treatment regimens associated with CS were evaluated using multivariable regression analysis.
RESULTS: 1196 syphilis infected mothers and their 1207 infants were included in the analyses, and 116 infants were diagnosed with CS, providing an overall incidence of 9.61% (116/1207). Multivariable logistic regression analysis showed that increasing maternal age was barely associated with the risk of CS (adjusted odds ratio (aOR) = 0.97, 95% CI, 0.93-1.00, p = .047). Women with a high nontreponemal serum test titer (≥1:8) had a 126% increased risk of delivering an infant with CS than those with a low titer (<1:8) (aOR = 2.26, 95% CI, 1.51-3.39, p < .001). The risk for CS decreased significantly in infants born to mothers receiving adequate treatment than those receiving no treatment (aOR = 0.36, 95% CI, 0.21-0.61, p < .001).
CONCLUSIONS: Adequate treatment is critical for the prevention of CS. Further strategies focusing on early diagnosis and adequate treatment among syphilis infected pregnant women, particularly among those with younger age and high nontreponemal titer, should be strengthened to prevent CS.
摘要：
背景：缺乏关于经济欠发达地区先天性梅毒（CS）影响因素的研究，比如江西省，中国。
方法：基于江西省梅毒母婴传播预防管理信息系统进行回顾性研究,中国。纳入2013年1月1日至2018年6月2030日分娩≥28孕周并在该系统中登记的梅毒感染孕妇。使用多元回归分析评估与CS相关的产妇特征和治疗方案。
结果：分析中包括了1196名感染梅毒的母亲及其1207名婴儿，116名婴儿被诊断为CS，提供了9.61%的总发病率（116/1207）。多变量logistic回归分析显示，母亲年龄增加与CS风险几乎没有相关性（校正比值比（aOR）=0.97，95％CI，0.93-1.00，p=0.047）。非密螺旋体血清检测滴度高(≥1:8)的女性分娩CS婴儿的风险比低滴度(<1:8)的女性增加126%(aOR=2.26,95%CI,1.51-3.39,p<.001)。与未接受治疗的母亲相比，接受适当治疗的母亲所生婴儿的CS风险显着降低（aOR=0.36，95％CI，0.21-0.61，p<.001）。
结论：适当的治疗对于预防CS至关重要。进一步的策略侧重于梅毒感染孕妇的早期诊断和适当治疗，特别是那些年龄较小、非密螺旋体滴度较高的人，应加强预防CS。
方法：基于江西省梅毒母婴传播预防管理信息系统进行回顾性研究,中国。纳入2013年1月1日至2018年6月2030日分娩≥28孕周并在该系统中登记的梅毒感染孕妇。使用多元回归分析评估与CS相关的产妇特征和治疗方案。
结果：分析中包括了1196名感染梅毒的母亲及其1207名婴儿，116名婴儿被诊断为CS，提供了9.61%的总发病率（116/1207）。多变量logistic回归分析显示，母亲年龄增加与CS风险几乎没有相关性（校正比值比（aOR）=0.97，95％CI，0.93-1.00，p=0.047）。非密螺旋体血清检测滴度高(≥1:8)的女性分娩CS婴儿的风险比低滴度(<1:8)的女性增加126%(aOR=2.26,95%CI,1.51-3.39,p<.001)。与未接受治疗的母亲相比，接受适当治疗的母亲所生婴儿的CS风险显着降低（aOR=0.36，95％CI，0.21-0.61，p<.001）。
结论：适当的治疗对于预防CS至关重要。进一步的策略侧重于梅毒感染孕妇的早期诊断和适当治疗，特别是那些年龄较小、非密螺旋体滴度较高的人，应加强预防CS。
