摘要：
Objective To investigate the incidence of adverse pregnancy outcomes among women with syphilis in Zhejiang province during 2013-2014,and to explore the influence of anti⁃syphilis treatment on pregnancy outcomes. Methods A retrospective study was carried out according to the Information Management System for preventing mother⁃to⁃child transmission(PMTCT)of syphilis in Zhejiang province during 2013-2014. The incidence of adverse pregnancy outcomes was compared between women with syphilis and general women without syphilis, between treated and untreated women with syphilis, as well as between women with syphilis receiving and not receiving standard anti⁃syphilis treatment. The effects of anti⁃syphilis treatment and standard anti⁃syphilis treatment on pregnancy outcomes were analyzed. Results Data were collected from 3 985 women with syphilis and their children. Of these women, 12 had a stillbirth, and 3 973 a live birth. Totally, 3 210(80.55%)women received anti⁃syphilis treatment, 967(30.12%, 967/3 210) women received substandard treatment, and 775(19.45%)did not receive anti⁃syphilis treatment. Of the 3 985 fetuses or neonates born to women with syphilis, 45(1.13%)had abnormal clinical symptoms/signs. The incidence rates of low birth weight and early neonatal death were 7.00%(279/3 985) and 1.13%(45/3 985) respectively in fetuses or neonates born to women with syphilis, both significantly higher than those in fetuses or neonates born to general women without syphilis (3.18%[26 092/819494] and 0.13%[1 029/819 494], respectively, both P < 0.01). Among 775 untreated women with syphilis, the incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs were 15.61%(121/775), 10.84%(84/775), 2.45%(19/775), 3.48%(27/775)and 2.84%(22/775)respectively, all significantly higher than those in 3 210 women receiving anti⁃syphilis therapy (8.26%, 6.07%, 0.81%, 0.81% and 1.03%,respectively, all P < 0.01). Besides, the 967 women receiving substandard anti⁃syphilis treatment showed higher incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs than the 2 243 women receiving standard treatment (10.44%vs. 7.31%, 8.17%vs. 5.17%, 1.55%vs. 0.49%, 1.65%vs. 0.45%, 1.96%vs. 0.62%, respectively, all P<0.01). Conclusions The incidence of adverse pregnancy outcomes is high among women with syphilis in Zhejiang province during 2013-2014. Untreated and inadequately treated maternal syphilis is strongly associated with adverse pregnancy outcomes.%目的：了解浙江省2013—2014年梅毒孕产妇不良妊娠结局发生情况，探讨抗梅毒治疗对妊娠结局的影响。方法回顾性分析浙江省2013—2014年预防梅毒母婴传播信息管理系统资料，比较梅毒孕产妇与同时段一般孕产妇不良妊娠结局发生差异。同时，按照治疗情况对梅毒孕产妇分组，比较是否治疗及是否规范治疗对妊娠结局的影响。结果共收集3985例梅毒孕产妇及其所分娩胎儿/婴儿信息，其中死胎12例，活产3973例。3985例梅毒孕产妇中接受抗梅毒治疗3210例占80.55%，未治疗775例占19.45%。3210例接受治疗的患者中，未规范治疗967例占30.12%。分娩的3985例胎婴儿中有异常症状/体征45例占1.13%；低出生体重279例，发生率7.00%；早期新生儿死亡45例，发生率1.13%，后两项均高于一般孕产妇[819494例中低出生体重儿26092例（3.18%），早期新生儿死亡1029例（0.13%）]，差异均有统计学意义（P<0.01）。775例未治疗的梅毒孕产妇中，早产121例（15.61%），低出生体重84例（10.84%），早期新生儿死亡19例（2.45%），胎传梅毒27例（3.48%）和新生儿异常症状/体征22例（2.84%），均分别高于3210例接受治疗的梅毒孕产妇（8.26%、6.07%、0.81%、0.81%、1.03%，均P<0.01）。967例未规范治疗的梅毒孕产妇早产（10.44%）、低出生体重儿（8.17%）、早期新生儿死亡（1.55%）、胎传梅毒（1.65%）和新生儿异常症状/体征发生率（1.96%）均高于2243例规范治疗的梅毒孕产妇（7.31%、5.17%、0.49%、0.45%、0.62%，均P<0.01）。结论浙江省2013—2014年梅毒孕产妇不良妊娠结局发生率较高，未治疗及未规范治疗的妊娠期梅毒严重威胁正常妊娠。
