目的探讨孕产妇妊娠期梅毒母婴阻断治疗对新生儿预后的影响,以期为临床治疗方法的选择提供参考。方法回顾性分析2019年1月—2020年12月在福建省厦门市接受诊治的220例妊娠合并梅毒患者的临床资料,根据患者妊娠期是否规范梅毒母婴阻断干预治疗分为未规范治疗组110例(患者治疗依从性差,未全程实施规范梅毒母婴阻断治疗)和规范治疗组110例(实施规范梅毒母婴阻断治疗)。比较两组患者妊娠结局、新生儿预后情况、新生儿快速血浆反应素环状卡片试验(rapid plasma reagin ring card test,RPR)滴度。结果规范治疗组流产、早产、死产等不良妊娠结局发生率明显低于未规范治疗组(χ²=8.143,P<0.05)。规范治疗组低体重儿、新生儿窒息、新生儿死亡、先天梅毒等不良新生儿预后发生率明显低于未规范治疗组(χ²=45.820,P<0.05)。两组新生儿出生时RPR滴度比较差异具有统计学意义(χ²=12.549,P<0.05)。规范治疗组出生后3个月RPR下降滴度数明显高于未规范治疗组(t=2.885,P<0.05),滴度下降至正常所需时间明显低于未规范治疗组(t=-11.463,P<0.05)。结论对妊娠期梅毒患者采用规范性母婴阻断治疗,有利于改善妊娠结局,阻断梅毒垂直传播,降低先天梅毒及不良新生儿结局发生率,促进新生儿血清RPR滴度降低。

Objective To investigate the effect of syphilis treatment during pregnancy on the prognosis of newborns, in order to provide evidence for clinical practice.Methods The clinical data of 220 pregnant women with syphilis treated in Xiamen from January2019 to December 2020 were analyzed. Based on the protocol for treatment, the patients were divided into 2 groups: 110 cases in the non-standardized treatment group(pregnant women didn' t receive appropriate therapy with poor compliance) and 110 cases in the standardized treatment group(pregnant women received appropriate therapy). Pregnancy outcomes, neonatal prognosis and neonatal serum rapid plasma reagin ring card test( RPR) titer were compared between two groups.Results The incidence of adverse pregnancy outcomes include abortion, premature birth and stillbirth in the standardized treatment group was significantly lower than that in the non-standardized treatment group(χ²= 8. 143,P< 0. 05). The incidence of low birth weight, neonatal asphyxia, neonatal death and congenital syphilis in the standardized treatment group was significantly lower than that in the non-standardized treatment group(χ²= 45. 820,P< 0. 05). RPR titer was significantly different between the two groups at birth(χ²= 12. 549,P< 0. 05). RPR titer after birth 3 months decreased more in the standardized treatment group than that in the non-standardized treatment group(t= 2. 885,P< 0. 05), and the time required for the serum titer to reach normal range was significantly shorter than that in the non-standardized treatment group(t=-11. 463,P< 0. 05).Conclusion Standardized therapy of syphilis during pregnancy is beneficial for improving pregnancy outcomes, prenvention of mother-to-child transmission, reducing the incidence of neonatal adverse outcomes and congenital syphilis, and promot neonatal serum RPR titer to decline.