| Objective:1.By collecting cases of syphilis in pregnancy,the status of syphilis infection in pregnancy and the incidence of adverse pregnancy outcomes were analyzed,the factors influencing the incidence of adverse pregnancy outcomes were analysed.2.Through the application of syphilis serology test in the early diagnosis of congenital syphilis,the advantages and disadvantages of related serological tests were explored.Methods:1.A retrospective study was conducted to collect 182 cases of gestational syphilis from the First affiliated Hospital of Chengdu Medical College of Chengdu,Sichuan Province,from January 1st,2009 to December 31 th,2017.Medical records from January 2009 to September 2014 are sourced from fy medical records system.Medical records from October 2014 to the end of 2017 are derived from Donghua medical records system.2.In the multifactor analysis of APOs of pregnant syphilis,according to the pregnancy outcomes,the normal group and the adverse pregnancy outcomes group(APOs group)were included to analyze the correlation and the risk of the social characteristics,clinical features and treatments with APOs.3.In the study of syphilis serology test used in CS,congenital syphilis was included in the CS group.Mothers of the CS group were included in the adult group.And the rest of the newborns without syphilis infection were included in the negative control group.The differences between the TRUST and the TPPA trials were compared between the groups.Results:1.In the multifactorial study of APOs of gestational syphilis: there was a correlation between APOs and the age,education level,occupation,resident status,marital status,drinking history,history of syphilis,spouse syphilis infection,confirmed pregnancy week,umbilical cord around neck,the initial syphilis titer logarithm,end of pregnancy syphilis titer logarithm,syphilis infection stage,and treatment norms in the2.single-factor study(P<0.05).In the logistic regression analysis,the results showed that the resident status(OR=6.018,95%CI=1.168~31.008,P=0.032),education level(OR=3.562,95%CI=1.448~8.761,P=0.006),confirmed pregnancy week(OR=3.081,95%CI=1.262~7.521,P=0.013),treatment criterion(OR=2.464,95%CI=1.303~4.661,P=0.006),logarithmic value of first-time syphilis titers(OR=30.861,95%CI=1.186~803.184,P=0.039),and end of pregnancy syphilis titer logarithm(OR=30.118,95%CI=1.641~552.739,P=0.022)had independent influence on the occurrence of APOs.3.In the study of syphilis serological test used in the early diagnosis of CS: the positive rate of the TPPA test in the adult and CS groups was 100.0%.The positive rate(100.0%)of the TRUST test in adult group was higher than that in CS Group(79.0%),and the difference was statistically significant(P<0.05).The sensitivity of the TRUST test(79.0%)of the neonatal was lower than that of the TPPA test(100.0%),and the difference was statistically significant(P<0.05).The missed diagnosis rate of the TRUST trial(21.0%)was higher than that of the TPPA tria(0.0%),and the difference was statistically significant(P<0.05).The negative predictive value of the TRUST test(85.4%)was lower than that of the TPPA test(100.0%),and the difference was statistically significant(P<0.05).Conclusion:1.the lower the education level of pregnant women,the status of floating population,the higher the titer of syphilis in the first diagnosis,the higher the syphilis titer before the end of pregnancy,the closer to the delivery period,and the less standardized treatment and even untreated,the higher the risk of APOs in patients with syphilis in pregnancy.2.The TRUST test has a high rate of missed diagnosis in the neonatal.The author does not recommend using TRUST trial as an initial screening test for CS.Traditional TPPA diagnostic tests still have high sensitivity and specificity. |
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