ABSTRACT
Objective:To investigate the anti-syphilis treatment status among pregnant women with syphilis and its influencing factors, and to explore the relationship between the treatment status and pregnancy outcome.Methods:Through the National Information System for the Prevention of Mother-to-child Transmission of acquired immune deficiency syndrome (AIDS), Syphilis and Hepatitis B, the demographic data, anti-syphilis treatment status during pregnancy and pregnancy outcomes of 1 614 pregnant women with syphilis who gave birth in Guangzhou City from January 2013 to December 2016 were collected. Chi-square test was used for comparison between groups and logistic regression method was used to identify influence factors of syphilis treatment and adverse pregnancy outcomes.Results:A total of 1 614 pregnant women with syphilis were included. The rates of standard treatment, general treatment and no treatment were 37.17%(600/1 614), 40.77%(658/1 614) and 22.06%(356/1 614), respectively. Logistic regression analysis showed that the rate of standard treatment was lower in the women with nonlocal registered permanent residence (adjusted odds ratio ( aOR)=0.670, 95% confidence interval ( CI) 0.523-0.858, P=0.002), unmarried ( aOR=0.582, 95% CI 0.393-0.863, P=0.007), education level of high school ( aOR=0.691, 95% CI 0.507-0.943, P=0.020), education level of junior middle school or below ( aOR=0.607, 95% CI 0.459-0.803, P<0.01), diagnosis after 28 weeks ( aOR=0.088, 95% CI 0.062-0.125, P<0.01) and unknown non-treponema pallidum antigen serologic test result at the time of diagnosis ( aOR=0.459, 95% CI 0.297-0.710, P=0.001). After controlling other related factors, compared with standard treatment group, the risk of adverse pregnancy outcome was increased in general treatment and untreated group, with aOR of 1.553 (95% CI 1.079-2.234, P=0.018) and 2.097 (95% CI 1.347-3.267, P<0.01), respectively. Compared to mothers with non-treponema pallidum antigen serologic test result ≤1∶4 at the time of diagnosis, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=1.542, 95% CI 1.105-2.152, P=0.011). Compared to mothers with negative non-treponema pallidum antigen serologic test result at the last test during pregnancy, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=2.063, 95% CI 1.151-3.700, P=0.015). Conclusion:Early diagnosis of syphilis, standard treatment and follow-up during pregnancy can effectively improve the pregnancy outcomes of pregnant women with syphilis.
ABSTRACT
Objective@#To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou.@*Methods@#Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations.@*Results@#The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for-age and body height-for-age than the World Health Organization’s reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05).@*Conclusion@#The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.