Fetal mortality and morbidity.

ObjectivesTo evaluate the fetal and neonatal morbidity and mortality in pregnant women with syphilis during their pregnancy in Reunion Island, population benefiting from early and well-conducted screening and treatment.MethodsThis is a retrospective observational study conducted in the four Reunion hospital centers between 2017 and 2022. The included patients were all pregnant patients with a biologically proven syphilitic infection and having given birth in one of the four centers mentioned.Results108 patients were included, with 113 fetuses and newborns. Fetal mortality rate was 2.7%, neonatal mortality rate was 1.8% and congenital syphilis rate was 7%. Despite 37% of patients with a vulnerable psycho-social context, 72% were screened early, 13% in the second trimester, 44% had received optimal treatment and 48% optimal syphilis monitoring. We found 43% of obstetric complications with 12% of IUGR and 4.6% of pre-eclampsia. 21% of newborns were preterm and 17% small for gestational age. There was a significant trend between psycho-social vulnerability and congenital syphilis.ConclusionsFetal and neonatal morbidity and mortality is low in our Reunion Island population where screening and treatment of syphilis are early and well conducted, although a vulnerable group of patients remain who require specific antenatal care.

【研究目的】评估留尼旺岛（Reunion Island）梅毒孕妇在妊娠期间的胎儿及新生儿发病率与死亡率，该人群可获得早期且规范的梅毒筛查与治疗。
【研究方法】本研究为回顾性观察性研究，于2017年至2022年间在留尼旺岛四家医疗中心开展。纳入对象为经生物学检测证实感染梅毒、且在上述四家医疗中心之一完成分娩的孕妇。
【研究结果】本研究共纳入108例患者，涉及113例胎儿及新生儿。胎儿死亡率为2.7%，新生儿死亡率为1.8%，先天性梅毒发生率为7%。尽管37%的患者存在社会心理脆弱性，但72%的患者接受了早期筛查，13%的筛查于妊娠中期开展，44%的患者接受了规范化梅毒治疗，48%的患者完成了规范化梅毒监测。研究发现43%的患者出现产科并发症，其中胎儿生长受限（intrauterine growth restriction, IUGR）占12%，子痫前期（preeclampsia）占4.6%。21%的新生儿为早产儿，17%为小于胎龄儿。社会心理脆弱性与先天性梅毒存在显著相关性。
【研究结论】留尼旺岛人群因梅毒筛查与治疗开展早期且规范，胎儿及新生儿的发病率与死亡率处于较低水平，但仍存在一部分需要针对性产前保健的高危患者群体。