METHODS: Women from the miscarriage, vaginal delivery, and C-section wards from a large maternity hospital in Lima with or without syphilis diagnosis were enrolled and their pregnancy outcomes compared. Maternal syphilis status using maternal blood and child serostatus using cord blood were determined by rapid plasma reagin (RPR) and rapid syphilis tests. The newborns\' clinical records were used to determine congenital syphilis.
RESULTS: A total of 340 women were enrolled, 197 were positive and 143 were negative for RPR/rapid syphilis tests. Antibody titers in sera from cord and maternal blood were comparable with RPR titers and were highly correlated (rho = 0.82, P <0.001). Young age (P = 0.009) and lower birth weight (P = 0.029) were associated with gestational syphilis. Of the women with gestational syphilis, 76% had received proper treatment. Mothers of all newborns with congenital syphilis also received appropriate treatment. Treatment of their sexual partners was not documented.
CONCLUSIONS: Syphilis during pregnancy remains a major cause of the fetal loss and devastating effects of congenital syphilis in newborns.
方法:流产的妇女,阴道分娩,利马一家大型妇产医院的剖腹产病房,纳入或未诊断为梅毒患者,并比较其妊娠结局.通过快速血浆反应蛋白(RPR)和快速梅毒试验(RST)确定使用母体血液的母亲梅毒状况和使用脐带血的儿童血清状况。新生儿临床记录用于确定先天性梅毒。
结果:在340名女性样本中,RPR/RST阳性197例,阴性143例。脐带血和母血血清中的抗体滴度与RPR滴度高度相关(rho:0·82,p<0·001)。年龄小(p=0·009)和出生体重低(p=0·029)与妊娠梅毒有关。在患有妊娠梅毒的女性中,76%的人接受过适当的治疗。所有患有先天性梅毒的新生儿的母亲也接受了适当的治疗。没有记录对其性伴侣的治疗。
结论:妊娠期间的梅毒仍然是胎儿丢失和新生儿先天性梅毒破坏性影响的主要原因。