Analysis Of Influencing Factors Of Fetal Loss In The Patients With Syphilis In Pregnancy

Objective:The infection rate of syphilis during pregnancy in Jilin province is close to that of high-incidence areas,but the control situation is obviously not as good as that in the economically developed areas of the south,and the incidence of fetal syphilis is on the rise.This study analyzed the cases of pregnancy with syphilis in a maternity hospital in Changchun to understand the epidemiological characteristics,clinical features,syphilis maternal infections and fetal loss of pregnant women with syphilis,as well as the influencing factors of fetal loss,to control maternal syphilis in Jilin province Infection and prevention of fetal loss in pregnant women with syphilis provide a theoretical basis.Methods:This study collected electronic medical records of all pregnant women and 455 the patients with syphilis in pregnancy admitted to a maternity hospital in Changchun from January 2013 to December 2018 for a cross-sectional study;according to whether the patients with syphilis in pregnancy had fetal loss,a 1:4 propensity score was used matching;the description of measurement data adopts median and interquartile range;the description of count data adopts rate(n)and composition ratio(%).The statistical analysis of measurement data adopts the rank sum test of two independent samples;the comparison of enumeration data between groups adopts the chi-square test or the exact probability method;the multivariate analysis adopts unconditional Logistic regression.Epidata 3.1 software was used to establish a database,and SPSS 24.0 software and R(v3.4.4)software were used for data analysis.Results:1.The total infection rate of the patients with syphilis in pregnancy in this hospital from 2013 to 2018 was 0.36%(455/125743);the average annual infection rates in each year were: 0.35%(57/16134),0.26%(52/20244),0.34%(43/12595),0.32%(65/20545),0.31%(55/17768)and 0.48%(183/38457).From 2013 to 2018,the annual fluctuation of the incidence of the patients with syphilis in pregnancy was around 0.3%,the lowest value was 0.16% in 2014,and the peak value was 0.48% in2018,showing an upward trend(P for trend<0.05).2.Demographic characteristics of 455 the patients with syphilis in pregnancy:the youngest is 16 years old,the oldest is 53 years old,and the median age is 28(24,31)years;the 25-29 year old age group has the largest number of 173 cases,accounting for 38.02%(173 /455),the 35-53 age group has at least 64 cases,accounting for 14.07%(64/455);unemployed people account for the majority,334 cases,accounting for 73.41%;urban distribution is mostly urban 63.96%(291 /455).3.Perinatal characteristics of 455 the patients with syphilis in pregnancy: 155cases(34.07%)were at most for the first pregnancy and 3 or more pregnancies,and the number of combined anemia cases was the most 134 cases(29.45%);the incidence of abnormal diagnosis of syphilis was the highest Umbilical cord entanglement,22.86%(104 cases);followed by premature rupture of membranes,16.48%(75 cases);90 cases received anti-syphilis treatment during pregnancy,accounting for 19.78%(90/455);syphilis rapid plasma responsive element Trial(RPR)low-titer patients(RPR≤1:8)totaled 335 cases(73.63%);the total number of adverse pregnancy outcomes was 246,of which 55 preterm births(12.09%)occurred the most,followed by low birth weight 53 Times(11.65%).4.Among 455 the patients with syphilis in pregnancy,69 cases of fetal loss occurred,with a total incidence of 15.16%;the incidence of fetal loss in pregnant women with syphilis from 2013 to 2018 was 29.82%(17/57)and 46.88%,respectively.(15/32),11.63%(5/43),16.92%(11/65),7.27%(4/55)and 9.29%(17/183);the peak was 46.88% in 2014,and there has been a significant decrease thereafter,The low value was 7.27% in 2017,and the incidence of fetal loss from2013 to 2018 showed a linear downward trend(P for trend<0.05).5.Logistic regression analysis of fetal loss in the patients with syphilis in pregnancy showed that there was no treatment during pregnancy(OR=2.87;95%CI:1.14-7.26),and high RPR titer(OR=1.37;95%CI:2.02-7.69),c-reactive protein(CRP)increased(OR = 2.35;95%CI:1.21-4.55),hemoglobin(HB)decreased(OR=5.38;95%CI:2.24-12.93)and reduced red blood cell volume width(RDW)(OR=8.30;95%CI:2.73-25.24))are related factors for fetal loss in the patients with syphilis in pregnancy.Conclusions:1.The majority of the patients with syphilis in pregnancy in this hospital are low-age,non-employed,and urban population;primiparas and patients who have not received anti-syphilis treatment during pregnancy are the majority;the incidence of abnormal diagnosis and anemia in the perinatal period is relatively high.2.The incidence of syphilis maternal fetal loss in the hospital showed a downward trend,3.3.Not receiving anti-syphilis treatment during pregnancy,high RPR titer(RPR>1:8),C-reactive protein(CRP)increase,hemoglobin(HB)and red blood cell volume distribution width(RDW)decrease,will increase the risk of fetal loss in patients with syphilis in pregnancy.