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目的调查广州市花都区孕妇梅毒感染率,并分析其危险因素,为孕妇梅毒控制工作提供借鉴。方法2012年10月至2014年9月期间,在花都区医疗机构登记进行孕期保健的孕妇及住院分娩的产妇进行梅毒检测,汇总梅毒甲苯胺红不加热血清试验(TRUST)和梅毒螺旋体明胶颗粒凝集试验(TPPA)阳性的全部孕产妇的个案资料,计算梅毒感染率。同时通过非匹配病例对照研究分析感染梅毒的危险因素。结果广州市花都区孕产妇梅毒感染率为0.42%。多因素Logistic回归分析显示,感染梅毒的危险因素包括:农村孕妇[比值比(OR)=2.42,95%可信区间(CI):1.07~5.48]、失业或待业(OR=5.69,95%CI:2.31~14.00)、中专及以下学历(OR=10.50,95%CI:2.28~48.47)、异常妊娠史(OR=2.68,95%CI:1.05~6.85)、配偶性病史(OR=44.46,95%CI:10.87~181.80)、无定期产检(OR=6.83,95%CI:2.55~18.33)、初次性行为年龄在20岁之前(OR=4.31,95%CI:1.81~10.26)、不洁性接触史、使用安全套频率不足25%(OR=5.23,95%CI:2.06~13.28)等8个因素。结论广州市花都区孕产妇梅毒感染危险因素复杂,应针对这些因素采取有效的干预措施,控制孕妇梅毒流行。
Objective To investigate the prevalence of syphilis infection in pregnant women in Huadu District of Guangzhou City and to analyze the risk factors for the syphilis control in pregnant women. Methods From October 2012 to September 2014, pregnant women registered in Huadu District Medical Institution for health care during pregnancy and hospitalized women during hospitalization were tested for syphilis, and the syphilis toluidine red unheated serum test (TRUST) and Treponema pallidum gelatin granules Agglutination test (TPPA) positive for all pregnant women case data to calculate the syphilis infection rate. At the same time, the risk factors of syphilis infection were analyzed by unmatched case-control study. Results The maternal syphilis infection rate was 0.42% in Huadu District of Guangzhou City. Multivariate Logistic regression analysis showed that the risk factors for syphilis infection in rural areas were: rural pregnant women [odds ratio (OR) = 2.42, 95% confidence interval (CI): 1.07 to 5.48], unemployed or unemployed (OR = 5.69, 95% CI : 2.31 ~ 14.00), secondary and below education (OR = 10.50,95% CI: 2.28-48.47), abnormal pregnancy history (OR = 2.68,95% CI: 1.05-6.85) (OR = 4.31, 95% CI: 1.81-10.26), unclean (95% CI: 10.87-181.80), no prenatal diagnosis (OR = 6.83, 95% CI: 2.55-18.33) Sexual contact history, the use of condoms frequency less than 25% (OR = 5.23,95% CI: 2.06 ~ 13.28) and other 8 factors. Conclusions The risk factors of syphilis infection in pregnant women in Huadu District of Guangzhou City are complex. Effective interventions should be taken according to these factors to control the prevalence of syphilis in pregnant women.