Abstract：
Syphilis, a disease once in decline, has made a resurgence worldwide. New Zealand has had increasing syphilis rates since enhanced syphilis surveillance was initiated in 2013. This study reports epidemiologic, descriptive and treatment data on management of infants prenatally exposed or vertically infected with syphilis across New Zealand as reported by pediatricians.
Over a 26-month period from April 2018 to May 2020 (inclusive), pediatricians throughout New Zealand notified potential, probable and confirmed cases of congenital syphilis to the New Zealand Pediatric Surveillance Unit. National reporting numbers were concurrently ascertained to demonstrate reporting accuracy.
Thirty-two cases were notified, comprised of 25 infants born to women with positive antenatal syphilis serology (5 whom developed congenital syphilis), and 7 infants diagnosed with congenital syphilis after birth where syphilis was not diagnosed in pregnancy. There were 12 cases of congenital syphilis; an incidence rate of 9.4 cases per 100,000 live births. Nine of the 12 infants had clinical features of congenital syphilis. One-third of maternal infections were early syphilis, and the women who gave birth to infected infants were less likely to have received antenatal care, adequate treatment and follow-up monitoring of treatment for syphilis during pregnancy.
This study quantifies an important burden of disease from congenital syphilis in our population. Case finding and treatment of syphilis in pregnancy are critical to prevent this. Our findings support the urgent need for measures such as repeat maternal syphilis screening in early third trimester; whether by affected region or instituted for all, in the context of rising cases.
Over a 26-month period from April 2018 to May 2020 (inclusive), pediatricians throughout New Zealand notified potential, probable and confirmed cases of congenital syphilis to the New Zealand Pediatric Surveillance Unit. National reporting numbers were concurrently ascertained to demonstrate reporting accuracy.
Thirty-two cases were notified, comprised of 25 infants born to women with positive antenatal syphilis serology (5 whom developed congenital syphilis), and 7 infants diagnosed with congenital syphilis after birth where syphilis was not diagnosed in pregnancy. There were 12 cases of congenital syphilis; an incidence rate of 9.4 cases per 100,000 live births. Nine of the 12 infants had clinical features of congenital syphilis. One-third of maternal infections were early syphilis, and the women who gave birth to infected infants were less likely to have received antenatal care, adequate treatment and follow-up monitoring of treatment for syphilis during pregnancy.
This study quantifies an important burden of disease from congenital syphilis in our population. Case finding and treatment of syphilis in pregnancy are critical to prevent this. Our findings support the urgent need for measures such as repeat maternal syphilis screening in early third trimester; whether by affected region or instituted for all, in the context of rising cases.
摘要：
梅毒,一种曾经衰退的疾病，在全球范围内实现了复兴。自2013年开始加强梅毒监测以来，新西兰的梅毒发病率一直在上升。这项研究报告了流行病学，儿科医生报告的关于新西兰产前暴露或垂直感染梅毒婴儿管理的描述和治疗数据。
从2018年4月到2020年5月（含）的26个月期间，新西兰各地的儿科医生通知潜在的，新西兰儿科监测单位可能和确诊的先天性梅毒病例。同时确定了国家报告数量，以证明报告的准确性。
已通知32例,由25名产前梅毒血清学阳性的妇女（5名患有先天性梅毒）出生的婴儿组成，7名出生后被诊断患有先天性梅毒的婴儿，在怀孕期间未被诊断出梅毒。先天性梅毒12例；发病率为每100,000例活产9.4例。12名婴儿中有9名具有先天性梅毒的临床特征。三分之一的产妇感染是早期梅毒，生下感染婴儿的妇女接受产前护理的可能性较小，妊娠期梅毒治疗的适当治疗和随访监测。
这项研究量化了我们人群中先天性梅毒的重要疾病负担。妊娠梅毒的病例发现和治疗对于预防这种情况至关重要。我们的研究结果支持迫切需要采取措施，例如在妊娠晚期早期重复进行孕产妇梅毒筛查;无论是受影响地区还是为所有人制定，在案件上升的背景下。
从2018年4月到2020年5月（含）的26个月期间，新西兰各地的儿科医生通知潜在的，新西兰儿科监测单位可能和确诊的先天性梅毒病例。同时确定了国家报告数量，以证明报告的准确性。
已通知32例,由25名产前梅毒血清学阳性的妇女（5名患有先天性梅毒）出生的婴儿组成，7名出生后被诊断患有先天性梅毒的婴儿，在怀孕期间未被诊断出梅毒。先天性梅毒12例；发病率为每100,000例活产9.4例。12名婴儿中有9名具有先天性梅毒的临床特征。三分之一的产妇感染是早期梅毒，生下感染婴儿的妇女接受产前护理的可能性较小，妊娠期梅毒治疗的适当治疗和随访监测。
这项研究量化了我们人群中先天性梅毒的重要疾病负担。妊娠梅毒的病例发现和治疗对于预防这种情况至关重要。我们的研究结果支持迫切需要采取措施，例如在妊娠晚期早期重复进行孕产妇梅毒筛查;无论是受影响地区还是为所有人制定，在案件上升的背景下。
