Factors affecting the treatment of syphilis infection among pregnant and lying-in women in Zhejiang Province
CHEN Yinwei1, LIN Dan1, YAO Qiang2, ZHANG Xiaohui1
1. Department of Women's Health, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China; 2. Sichuan University, Chengdu, Sichuan 610044, China
Abstract：Objective To investigate the current status of syphilis treatment and its influencing factors among pregnant and lying-in women in Zhejiang Province, so as to promote the standardized treatment for pregnant and lying-in women with syphilis. Methods The sociodemographic characteristics ( age, educational level, ethnicity, marital status, occupation ), fertility ( gravidity, parity, number of children, and adverse pregnancy history ), gestational week at the first antenatal care visit and syphilis treatment ( treatment or not, standardized treatment or not, and antibody titer ) were collected from the pregnant and lying-in women with syphilis infections delivered in Zhejiang Province in 2018, based on the Zhejiang Provincial Information Management System for Prevention of Mother-to-Child Transmission of AIDS, Syphilis and Hepatitis B. Factors affecting the treatment of syphilis infections were identified using a structural-equation model. Results A total of 2 061 pregnant and lying-in women with syphilis infections were included, with a median age of 29 years and a mean gestational week at the first antenatal care visit of ( 14.33±11.85 ) weeks, and there were 844 women ( 40.95% ) diagnosed in early pregnancy ( <13 weeks of gestational age ). There were 1 978 cases ( 95.97% ) receiving syphilis treatment, and 1 616 cases ( 78.41% ) received standardized treatment. The structural-equation modeling analysis showed that the gestational age at the first antenatal care visit and fertility had direct impacts on the treatment of syphilis infections among pregnant and lying-in women, with standardized path coefficients of -0.187 and -0.157 (both P<0.05 ), respectively, and the sociodemographic characteristics affected the treatment of syphilis through the mediating role of fertility, with a standardized path coefficient of 0.070 ( P<0.05 ). Conclusions The proportion of syphilis treatment is more than 95% among pregnant and lying-in women in Zhejiang Province, which achieves the required process criteria for validation of elimination of mother-to-child transmission of HIV and syphilis. Gestational week at the first antenatal care visit, fertility status, and sociodemographic characteristics are factors affecting the treatment syphilis infections during pregnancy.
陈银炜, 林聃, 姚强, 张晓辉. 浙江省梅毒感染孕产妇梅毒治疗的影响因素研究[J]. 预防医学, 2022, 34(4): 330-334.
CHEN Yinwei, LIN Dan, YAO Qiang, ZHANG Xiaohui. Factors affecting the treatment of syphilis infection among pregnant and lying-in women in Zhejiang Province. Preventive Medicine, 2022, 34(4): 330-334.
[1] QIAO Y,WANG X,WANG Q,et al.Screening and treatment of syphilis for pregnant women-China,2011-2018[J].China CDC Wkly,2020,2(26):476-480. [2] World Health Organization.Data on syphilis[EB/OL].[2022-02-08].https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/data-on-syphilis. [3] 古亦斌,李阳,朱丽萍,等.上海市2013年至2015年梅毒感染孕产妇治疗情况及其不良妊娠结局相关因素分析[J].中华传染病杂志,2019,37(4):214-219. GU Y B,LI Y,ZHU L P,et al.Treatment status of maternal syphilis infection and factors associated with their adverse pregnant outcomes in Shanghai during 2013-2015[J].Chin J Infect Dis,2019,37(4):214-219. [4] 李珍,王前,乔亚萍,等.2017年我国梅毒感染孕产妇梅毒治疗情况及影响因素分析[J].中国艾滋病性病,2021,27(1):60-63. LI Z,WANG Q,QIAO Y P,et al.Maternal syphilis treatment and associated factors analysis in China,2017[J].Chin J AIDS STD,2021,27(1):60-63. [5] World Health Organization.Global guidance on criteria and processes for validation:elimination of mother-to-child transmission(EMTCT)of HIV and syphilis[EB/OL].[2022-02-08].https://www.who.int/reproductivehealth/publications/rtis/9789241505888/en. [6] LI Z,WANG Q,QIAO Y P,et al.Incidence and associated predictors of adverse pregnancy outcomes of maternal syphilis in China,2016-19:a Cox regression analysis[J].BJOG,2021,128(6):994-1002. [7] 陈冠锋,郭庆云,邵森,等.浙江地区梅毒感染孕产妇治疗现状及不良妊娠结局因素分析[J].中国计划生育学杂志,2020,28(9):1346-1350. CHEN G F,GUO Q Y,SHAO S,et al.Analysis of the treatment status and adverse pregnancy outcomes of pregnant women with syphilis infection in Zhejiang region[J].Chin J Fam Plann,2020,28(9):1346-1350. [8] 孙瑜,施卸丽,邱丽倩,等.浙江省梅毒感染流动孕产妇预防母婴传播服务利用情况及其影响因素[J].中国公共卫生,2021,37(2):238-243. SUN Y,SHI X L,QIU L Q,et al.Utilization of mother-to-child transmission prevention service and its influencing factors among migrant pregnant women with syphilis infection in Zhejiang province[J].Chin J Public Health,2021,37(2):238-243. [9] 中华人民共和国卫生健康委员会.预防艾滋病、梅毒和乙肝母婴传播工作规范(2020年版)[J].中国实用乡村医生杂志,2021,28(2):10-11,20. National Health Commission of the People's Republic of China.Prevention of mother to child transmission of HIV,syphilis and hepatitis B(2020 Edition)[J].Chin Pract J Rural Doc,2021,28(2):10-11,20. [10] 胡慧,张淑云,邱景梅.2015—2018年江西省南昌市梅毒感染孕产妇治疗状况及其影响因素分析[J].中国艾滋病性病,2020,26(4):411-415. HU H,ZHANG S Y,QIU J M.Analysis of treatment status of syphilitic pregnant women and associated factors in Nanchang,Jiangxi province from 2015 to 2018[J].Chin J AIDS STD,2020,26(4):411-415. [11] 王行,王全丽,毕育学,等.陕西省育龄妇女产前检查的现状及影响因素分析[J].中国初级卫生保健,2018,32(5):20-23. WANG X,WANG Q L,BI Y X,et al.Analysis on the status and influencing factors of antenatal examination among the women of childbearing age in Shaanxi Province[J].Chin Prim Health Care,2018,32(5):20-23. [12] 田策,彭辉,LEE S,等.2012至2018年孕妇孕期保健情况分析[J].中国妇幼健康研究,2020,31(5):546-552. TIAN C,PENG H,LEE S,et al.Utilization of antenatal care services among pregnant women in Beijing from year 2012 to 2018[J].Chin J Woman Child Health Res,2020,31(5):546-552. [13] JIWANI S S,AMOUZOU-AGUIRRE A,CARVAJAL L,et al.Timing and number of antenatal care contacts in low and middle-income countries:analysis in the countdown to 2030 priority countries[J].J Glob Health,2020,10(1):1-12. [14] 刘小燕,卢德梅,刘惠桃.佛山市流动人口产妇母婴健康素养及影响因素分析[J].预防医学,2020,32(7):736-739. LIU X Y,LU D M,LIU H T.Status and influencing factors of maternal and infant health literacy among migrant puerperae in Foshan[J].Prev Med,2020,32(7):736-739. [15] 毛梁元,章建伟. 绍兴市梅毒感染孕产妇特征及妊娠结局分析[J]. 预防医学,2020,32(4):408-410. MAO L Y,ZHANG J W.Characteristics and pregnant outcome of the women infected with syphilis in Shaoxing[J].Prev Med,2020,32(4):408-410. [16] 沈惠良,王涧,严丽英,等. 梅毒患者血清固定的影响因素分析[J].预防医学,2021,33(6):589-591. SHEN H L,WANG J,YAN L Y,et al.Influencing factors for the serofast reaction in patients with syphilis[J].Prev Med,2021,33(6):589-591. [17] 杜小萍,胡奎,黄玲,等.妊娠期梅毒母婴用药及影响因素调查分析[J].安徽预防医学杂志,2017,23(1):53-56. DU X P,HU K,HUANG L,et al.Investigation on drug use of maternal and child with syphilis in pregnancy and its influencing factors[J].Anhui J Prev Med,2017,23(1):53-56.
