先天性梅毒带来了巨大的全球负担,导致胎儿丢失,死产,新生儿死亡率,和先天性感染。尽管世界卫生组织(世卫组织)在2007年确定了每10万活产不到50例的目标,全球发病率正在上升,特别是在中低收入地区。最近的数据表明,每10万活产婴儿中有473例病例,导致661,000例先天性梅毒,包括355,000个不良出生结局,例如早期胎儿死亡,死产,新生儿死亡,早产或低出生体重婴儿,和临床先天性梅毒的婴儿。令人震惊的是,这些不良结局中只有6%发生在登记的母亲身上,筛选,和治疗。与许多新生儿感染不同,通过有效的产前筛查和感染孕妇的治疗,先天性梅毒是可以预防的。然而,尽管有可用的筛查工具,负担得起的治疗选择,以及将预防计划纳入各国的产前保健,先天性梅毒仍然是全球紧迫的公共卫生问题。这篇综述旨在总结当前的流行病学,传输,和治疗妊娠梅毒,以及探索减少垂直传播的全球努力,并解决未能达到世卫组织消除目标的原因。
Congenital syphilis presents a significant global burden, contributing to fetal loss, stillbirth, neonatal mortality, and congenital infection. Despite the target established in 2007 by the World Health Organization (WHO) of fewer than 50 cases per 100,000 live births, the global incidence is on the rise, particularly in low- and middle-income regions. Recent data indicate a rate of 473 cases per 100,000 live births, resulting in 661,000 total cases of congenital syphilis, including 355,000 adverse birth outcomes such as early fetal deaths, stillbirths, neonatal deaths, preterm or low-birth-weight births, and infants with clinical congenital syphilis. Alarmingly, only 6% of these adverse outcomes occurred in mothers who were enrolled, screened, and treated. Unlike many neonatal infections, congenital syphilis is preventable through effective antenatal screening and treatment of infected pregnant women. However, despite available screening tools, affordable treatment options, and the integration of prevention programs into antenatal care in various countries, congenital syphilis remains a pressing public health concern worldwide. This review aims to summarize the current epidemiology, transmission, and treatment of syphilis in pregnancy, as well as to explore global efforts to reduce vertical transmission and address the reasons for falling short of the WHO elimination target.