Analysis Of Influencing Factors Of Adverse Pregnancy Outcome In 152 Pregnant Syphilis Infected Patients

ObjectivesTo investigate clinical features of pregnant women infected with syphilis and the factor that affect fetal outcome, reducing the vertical infection and protecting the health of the fetus, a scientific basis for clinical diagnosis and therapy and data for some related studies can be provided. MethodsThe object of study were 152 pregnant women infected with syphilis during January,1st, 2014 to December 31 th,2014 in a hospital in Changchun. “Pregnancy with syphilis in pregnant women case questionnaire” designed by ourselves was used. The method of retrospective study was adopted. The information was collected by using uniform standard. Serological detection was conducted by the hospital which contained RPR and TPPA. Epidate3.0 and SPSS21.0 were adopted to establish the database and data analysis. Quantitative variable was described by mean,standard deviation, median and quartile range; Qualitative variable was described by the constituent ratio and rate, compared by chi-square test, and the difference of the comparison between groups was statistically significant when p < 0.05. Results1. The average age of 152 pregnant women with syphilis was 29.68±5.58. In these research subjects, The Han nationality was 147 cases, accounted for 96.71%. Unemployed pregnant women with syphilis was 96 cases, accounted for 63.16%. Living in cities was 122 cases, accounted for 80.26%, the rest of them were living in rural area. 63.16% of pregnant women with syphilis had once or twice pregnancies. Pluripara were 36 cases, accounted for 23.68%. The pregnant women with syphilis who had abortion history were 79 cases and who had induction of labor were 4 cases.2. All patients were found TPPA positive; There were 89 patients in negative, 32 patients in ≤1:8 and 31 patients in≥1:16 in serum RPR titer.3. There were 5 cases(3.29%) with the hepatitis B virus infection status, 61 cases(40.13%) with the status of hypohemia, 17 cases(11.19%) with the status of hypertension, 7 cases(4.61%) with the status of gestational diabetes mellitus, 2 cases(1.32%) with the status of morning sickness in 152 pregnant women with syphilis.4. Pregnant patients with syphilis of abnormal diagnosis were 120 cases(78.95%) in perinatal, the premature rupture of membrane were 52 cases(34.21%), the oligohydramnios were 15 cases(9.87%).5. Pregnant patients with syphilis choosing vaginal delivery were 88cases(57.89%), cesarean delivery were 64 cases(42.11%).6. The live births were 137 case, stillbirth were 10 case and flow births were 5 case. The premature infant were 20 cases in live births. The Apgar score was used in live birth, one minute score with 0-3 points were 4 cases(2.92%), 4-7 points were 14 cases(10.22%).7. In 52 cases pregnant patients with syphilis, there were 35 cases which suffered from APOs. There were 15 cases(42.86%) in 17-24 years old. There were 34 cases(97.14%) in the Han nationality. The unemployed person were 19 cases(54.26%). There were 28 cases(80.00%) in cities and towns. There was significant difference between normal pregnancy outcome and age(P<0.05), however there was no significant difference between normal pregnancy outcome and nationality, occupation, residence(P>0.05). There was no significant difference between different times of pregnancy and abortion and APOs(P>0.05).8. In 35 cases who suffered from APOs, there were 16 cases combined with surgical disease, the incidence rate was 45.71%, which compared with the incidence of normal pregnancy outcome which combined with surgical disease, there was no significant difference(P>0.05).9. 35 cases of pregnant women with adverse pregnancy outcomes, 3 cases combined with hypertension, the incidence rate was 8.57%, 1 cases combined with gestational diabetes, the incidence rate was 2.86%. Which compared with the incidence of normal pregnancy outcome combined with those diseases, there was no significant difference(P>0.05).10. 35 cases of pregnant women with adverse pregnancy outcome, 29 cases did not receive anti syphilis treatment, the incidence rate was 82.86%. Whether or not accept anti syphilis treatment was associated with pregnancy outcome(OR=0.264, P = 0.011); 35 cases of pregnant women with adverse pregnancy outcome, 12 cases with RPR titer negative, the incidence rate was 34.29%; 8 cases with RPR titer ≤ 1:8, the incidence rate was 22.86%; 15 cases with RPR titer≥1:16, the incidence rate was 42.85%. RPR titer ≥1:16 was a greater risk of adverse pregnancy outcome(OR=6.507, P = 0.001), with the increase of the incidence rate of APOs, RPR titer also increase,and the result showed that there was an increasing trend(?2=15.319,P=0.000). Conclusions1. The incidence of APOs may be related to the RPR titer, RPR titer ≥1:16 was a greater risk of adverse pregnancy outcome, and with the increase of RPR titer, the incidence of APOs also increased;2. The outcome of pregnancy patients is associated with pregnancy patients whether receive antisyphilis treatment or not, the incidence rate of APOs after anti syphilis treatment is lower than the incidencerate of patients without treatment.