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目的:分析先天性梅毒病例报告的准确性及发生先天性梅毒的高危因素，为临床医师准确诊断先天性梅毒提供依据。方法:以2016年至2019年广州市“传染病网络直报系统”中上报的所有疑似、确诊先天性梅毒个案，以及2012年至2019年广州市“预防艾滋病、梅毒和乙肝母婴传播管理信息系统”中的确诊先天性梅毒个案、排除先天性梅毒个案为研究对象，对其人口学、梅毒血清学检测结果、上报医师信息和治疗等进行分析。采用n χ2检验进行单因素分析，采用多因素logistic回归分析先天性梅毒发生的影响因素。n 结果:“传染病网络直报系统”上报的95例先天性梅毒中，35例(36.8%)报告准确。患儿年龄0.05)。母亲分娩时年龄≤24岁[调整的比值比(adjusted odds ratio，n aOR)＝4.62]、治疗前非梅毒螺旋体抗原血清学效价≥1∶8(n aOR＝7.56)、产时启动驱梅治疗(n aOR＝25.43)、妊娠期未进行驱梅治疗(n aOR＝14.12)、早产(n aOR＝8.97)等均可增加先天性梅毒的发生风险(均n P0.05). Maternal age≤24 years (adjusted odds ratio (n aOR)=4.62), titers of non-n Treponema pallidum antigen serologic test before treatment≥1∶8 (n aOR=7.56), initiation of antisyphilitic treatment during delivery (n aOR=25.43), no antisyphilitic treatment during pregnancy (n aOR=14.12), and premature delivery (n aOR=8.97) increased the risks of CS (all n P<0.01).n Conclusions:The reporting accuracy rate of CS is low. Young mothers, high serological titers of non-n Treponema pallidum antigen before treatment, initiation of antisyphilitic treatment during delivery or no antisyphilitic treatment during pregnancy, and premature delivery are risk factors for CS. Doctors may focus on collecting this information to assist clinical diagnosis.n