妊娠梅毒RPR滴度对围产结局及新生儿血清学转归的影响
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Effects of rapid plasma regain titer of syphilis during pregnancy on perinatal outcome and serologic outcome of the newborn
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    目的:探讨孕母梅毒快速血浆反应试验(rapid plasma regain,RPR)滴度与新生儿RPR阳性率及围生结局关系。方法:对2009年1月1日—2014年2月1日经RPR和梅毒螺旋体颗粒凝集试验筛查,192例妊娠合并梅毒孕母分娩前及其部分新生儿出生时及6月龄时外周血检测,比较孕母RPR 滴度与新生儿RPR阳性率-阴转率及不良围生结局的关系。结果:新生儿RPR滴度与孕母呈正相关,孕母RPR滴度1∶1时,新生儿RPR阳性率68.4%;孕母RPR滴度1∶2时,新生儿RPR阳性率87.0%;当孕母RPR滴度≥1∶8时,新生儿RPR阳性率100.0%;孕母RPR滴度≥1∶8与≤1∶4比较,新生儿RPR阳性率差异有统计学意义(P < 0.05)。孕母RPR滴度≥1∶8时,婴儿6月龄RPR阴转率下降,与RPR滴度≤1∶4比较,差异有统计学意义(P < 0.05)。随着孕母RPR滴度的升高,畸形-死胎及新生儿死亡-早产及先天性梅毒的风险升高,婴儿不良结局风险升高。当孕母RPR滴度≥1∶8时,与孕母RPR滴度≤1∶4比较,新生儿畸形-早产-先天性梅毒增多,差异有统计学意义(P < 0.05)。结论:随着孕母RPR滴度的升高,新生儿RPR阳性率升高,当RPR滴度≥1∶8时,新生儿RPR阳性率为100%,6月龄阴转率下降,胎儿畸形-早产-先天性梅毒发生率显著升高。

    Abstract:

    Objective:To analyze the relationship between rapid plasma regain (RPR) titer of syphilis and adverse pregnancy outcomes in pregnant women and RPR positive rate of newborns. Methods:From Jan 1,2009 to Fab 1,2014,192 pregnant women with syphilis were screened by RPR test and treponema pallidum particle agglutination (TPPA) test before delivery and some of the newborn were screened for peripheral blood at birth and 6 months,so that to find the relationship between RPR titer of syphilis in pregnant women and RPR positive rate and negative conversion rate of the newborns,as well as the adverse pregnant outcomes in pregnant women with syphilis. Results:RPR titer of newborns was closely relative to their mothers. When RPR titer of pregnant women was 1∶1 and 1∶2,PRP positive rate of the newborns was 68.4% and 87.0%,respectively. When RPR titer of pregnant women was higher than 1∶8,PRP positive rate of the newborns reached 100% and higher than those with mother′s RPR titer was ≤1∶4 (P < 0.05). When RPR titer of pregnant women was ≥1∶8,the RPR negative conversion rate of the 6-month newborns was decreased,compared that with mother's RPR titer was ≤1∶4(P < 0.05). With the rise of RPR titer of pregnant woman,risk of malformation,stillbirth,preterm birth,congenital syphilis,neonatal death and adverse newborn outcome increased. Preterm birth,congenital syphilis and neonatal malformation rates were increased when RPR titer of pregnant women was ≥1∶8,compared that when RPR titer of pregnant women was ≤1∶4(P < 0.05). Conclusion:With the increase of RPR titer syphilis in pregnant women,PRP positive rate of the newborns was also increased. In addition,when RPR titer of pregnant women was ≥1∶8,PRP positive rate of the newborn reached 100%,the RPR negative conversion rate of the 6-month newborns was decreased, and occurrence rates of malformation,preterm birth and congenital syphilis were significantly increased.

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王根菊,韩国荣,江红秀,王翠敏,丁 祎,和沁园.妊娠梅毒RPR滴度对围产结局及新生儿血清学转归的影响[J].南京医科大学学报(自然科学版),2015,(11):1624-1627

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  • 收稿日期:2014-04-01
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  • 在线发布日期: 2015-11-30
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