| Objective To investigate the perinatal outcome of pregnancy syphilispatients, explore the influencing factors of mother-to-child transmission, and establish a nomogram prediction model to predict the risk of mother-to-child transmission. Methods?The clinical data of 324 pregnant women with syphilis who were admitted to our hospital between March 2018 and March 2022 were retrospectively analyzed. Perinatal outcomes were recorded and the patients were divided into 2 groups based on the presence or absence of mother-to-child transmission: a transmission group (32 cases) and a non-transmission group (292 cases). Logistic regression analysis was used to identify factors associated with mother-to-child transmission of syphilis during pregnancy, and a nomogram model was developed. The predictive efficacy and discrimination of the nomogram were evaluated using receiver operating characteristic curves and the Bootstrap method, respectively. Results?Among 324 pregnant women with syphilis, 32 cases had congenital syphilis. There were 123 cases of full-term delivery, 180 cases of full-term cesarean section, 8 cases of preterm delivery, 8 cases of preterm cesarean section, 2 cases of stillbirth, 3 cases of stillbirth. There were 2 cases of low birth quality infants and 1 case of malformed fetus. Multivariate Logistic regression analysis showed that the gestational week at initial pregnancy examination, the first rapid plasma reagin test titer≥1:8, untreated syphilis, non-standard medication and one course of treatment were risk factors for mother-to-child transmission of pregnancy syphilis (P＜0.05 ). The risk prediction nomogram model was constructed according to the results of multivariate analysis, and the receiver operating characteristic curve analysis results showed that the area under the curve sensitivity and specificity of the column diagram for predicting mother-to-child transmission in pregnant syphilis patients were 0.853 (95%CI: 0.810–0.890 ), 78.12 % and 86.99 % respectively. The Bootstrap method was used to verify the model, and the consistency index was 0.837, and the calibration curve and standard curve fitting were better. Conclusions?The gestational week at initial pregnancy examination, the first rapid plasma reagin test titer≥1:8, untreated syphilis, non-standard medication and one course of treatment are all risk factors for mother-to-child transmission of pregnancy syphilis patients, andthe nomogram model based on influencing factors can provide a reference for clinical early screening of pregnant syphilis patients with high-risk of mother-to-child transmission. |