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目的 调查孕妇梅毒患病率,并探讨苄星青霉素预防梅毒孕妇不良妊娠结局(APO)的作用.方法 利用病例对照研究,知情同意后采集孕妇血清,用梅毒螺旋体颗粒凝集实验(TPPA)和血清甲苯胺红不加热血清试验(TRUST)检测梅毒血清抗体,同时填写结构式问卷,将梅毒孕妇依据是否在孕期进行驱梅治疗分为干预组和对照组,分别随访至产后6个月.统计两组孕妇的APO发生率,并通过Logistic回归分析其危险因素.结果 202例出生儿中,APO 18例,其中4例合并胎传梅毒(CS).干预组及对照组APO率分别为2.38%、19.74%,差异有统计学意义(OR=8.94,95%CI:2.49~32.01),苄星青霉素治疗可将APO减少88.14%.产前TRUST≥1:16(OR=5.03,95%CI:1.18~21.47)、没有产前保健(OR=10.2,95%CI:1.33~78.34)、孕晚期干预或不干预(OR=5.58,95%CI:1.56~19.91)、临产才确诊梅毒(OR=3.49,95%CI:1.25~9.73)是发生APO的4个独立影响因素;多因素分析显示,孕妇梅毒晚期才干预是APO的高危因素(Wald=7.22,P=0.007,OR=5.74,95%CI:1.60~20.54).结论 梅毒孕妇APO的表现主要是早产、低体重以及发生CS,孕期苄星青霉素规范治疗可以大大减少APO发生率,尽早对梅毒孕妇驱梅干预可以改善妊娠结局.“,”Objective To investigate the syphilis prevalence among pregnant women and explore the effect of penicillin benzathine therapy to prevent adverse pregnant outcome (APO). Methods Case-control study was employed. Serum samples were collected from puerperants and tested for syphilis antibody with toluidine red unheated serum test (TRUST) and Treponema pallidium particle agglutination(TPPA),and structure questionnaire were fufilled with informed consent. Two hundred and two pregnant women were diagnosed with syphilis infection. They were divided into two groups based on receiving penicillin benzathine treatment or not during gestation and risk factors were analyzed by non parameter binary logistic regression. Results Of 202 Neonates born from syphilitics maternal ,18 of them were diagnosed as APO ,and 4 of 18 newborns were identified as congenital syphilis(CS). The APOs rates for both study group and control group were 2.38%and 19.74%,respectively,and exist significant difference(OR=8.94,95%CI:2.49~32.01). After penicillin benzathine intervention,the rate of APOs for those with both TRUST&TPPA seropositive decreased by 88.14% when compared to that without intervention. The independent risk factors related to APO including TRUST titers ≥1:16 before delivery(OR=5.03, 95%CI:1.18~21.47),pregnant women without antenatal care(OR=10.2,95%CI:1.33~78.34),pregnant women without anti-syphilitic treatment until the third trimester of pregnancy(OR=5.58,95%CI:1.56~19.91),and syphilis diagnose was not made untilprenatal period (OR=3.49,95%CI:1.25~9.73),and multivariate analysis showed that pregnant women without anti-syphilistic treatment until the third trimester of pregnancy was still a risk factor for APOs (Wald=7.22,P=0.007,OR=5.74,95%CI:1.60~20.54). Conclusion The APOs of syphilitic pregnant women,including premature birth, low birth weight and congenital syphilis ,was mainly associated with untreated syphilis. And enhancing antenatal care such as treating syphilis with penicillin benzathine as soon as possible during gestation could improve pregnant outcome.