Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China
The purpose of this investigation was to assess the effectiveness of an intervention program on mother-to-child transmission (MTCT) of syphilis and investigate determinants of congenital syphilis (CS) and adverse pregnancy outcomes (APOs). The Shenzhen local government initiated an intervention prog...
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Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2014-12, Vol.33 (12), p.2183-2198 |
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Sprache: | eng |
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Zusammenfassung: | The purpose of this investigation was to assess the effectiveness of an intervention program on mother-to-child transmission (MTCT) of syphilis and investigate determinants of congenital syphilis (CS) and adverse pregnancy outcomes (APOs). The Shenzhen local government initiated an intervention program of MTCT of syphilis in 2001. Based on this program, maternal and paternal factors associated with CS and APOs among syphilitic women were investigated from 2007 to 2012 by a prospective cohort study. From 2002 to 2012, 2,441,237 pregnant women were screened and screening coverage reached 97.2 % in 2012. In the background of continuing growth of CS in China, CS in Shenzhen significantly decreased from 109.3 cases in 2002 to 9.9 cases in 2012 per 100,000 live births. Maternal education (adjusted odds ratio [aOR]
CS
= 0.65; aOR
APOs
= 0.79) and history of syphilis (aOR
CS
= 0.28; aOR
APOs
= 0.61), as well as paternal age (aOR
CS
= 0.62; aOR
APOs
= 0.86) and education (aOR
CS
= 0.66; aOR
APOs
= 0.86) were negatively associated with CS and APOs, but maternal unmarried status (aOR
CS
= 1.95; aOR
APOs
= 2.61), inadequate antenatal care (ANC) (aOR
CS
= 3.61; aOR
APOs
= 1.79), more sexual partners (aOR
CS
= 1.51; aOR
APOs
= 1.39), every week of delay in treatment (aOR
CS
= 2.82; aOR
APOs
= 1.27), higher baseline titers of nontreponemal antibodies (aOR
CS
= 5.65; aOR
APOs
= 1.47), early syphilis (aOR
CS
= 23.24; aOR
APOs
= 26.95), and non-penicillin treatment (aOR
CS
= 3.00; aOR
APOs
= 2.16), as well as paternal history of cocaine use (aOR
CS
= 2.70; aOR
APOs
= 2.44) and positive (aOR
CS
= 4.14; aOR
APOs
= 1.50) or unknown (aOR
CS
= 2.37; aOR
APOs
= 2.06) status of syphilis increased the risk of CS and APOs. Condom use (aOR = 0.70) decreased MTCT of syphilis. A ten-year program consisting of screening and treatment, early ANC, health education, partners tracking, detection, and treatment, follow-up visits, and information management is an effective means to block MTCT of syphilis. Maternal and paternal factors constituted two separate profiles associated with MTCT of syphilis. |
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ISSN: | 0934-9723 1435-4373 |
DOI: | 10.1007/s10096-014-2186-8 |