Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
目的： 分析妊娠合并梅毒孕妇不同治疗时机与新生儿不良结局（早产、死亡、先天性梅毒）的关联。 方法： 利用国家“预防艾滋病、梅毒和乙肝母婴传播管理信息系统”监测收集的2011年10月至2021年12月广东省妊娠合并梅毒孕妇及其所生新生儿检测治疗等信息。根据梅毒孕妇首次进行青霉素治疗时所处孕周，分为孕早期治疗、孕中期治疗、孕晚期治疗和孕期未进行治疗4组。采用多因素logistic回归模型分析梅毒孕妇不同治疗时机与新生儿不良结局的关联。 结果： 共纳入22 483例梅毒孕妇，孕早期、孕中期、孕晚期启动治疗和孕期未进行治疗的孕妇分别为4 549例（20.23%）、8 719例（38.78%）、2 235例（9.94%）和6 980例（31.05%）。与孕早期启动治疗的孕妇相比，孕期未进行驱梅治疗的孕妇，其所生新生儿早产（OR=1.42，95%CI：1.24~1.62）、死亡（OR=4.27，95%CI：1.64~14.69）和先天性梅毒（OR=12.26，95%CI：6.35~27.45）发生风险均增加，孕中期（OR=2.68，95%CI：1.34~6.16）、孕晚期（OR=6.27，95%CI：2.99~14.80）启动驱梅治疗的孕妇，其所生新生儿罹患先天性梅毒的风险增加。 结论： 对妊娠合并梅毒孕妇，孕期应尽早启动驱梅治疗，以减少新生儿不良结局的发生。.