Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey.

Sule Ozel, Selen Yaman, Hatice Kansu-Celik, Necati Hancerliogullari, Nurgul Balci, Yaprak Engin-Ustun

Journal: Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia 2019;40(11):673-679

PMID: 30308685

Abstract

OBJECTIVE

 The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women.

METHODS

 Retrospective, observational study. A total of 576 Syrian refugees and 576 ethnic Turkish women were included in this study, which was conducted between January 2015 and December 2015 at a tertiary maternity training hospital in Ankara, Turkey. The demographic characteristics, obstetric and neonatal outcomes were compared. The primary outcomes were pregnancy outcomes and cesarean rates between the groups RESULTS:  The mean age was significantly lower in the refugee group ( < 0.001). Mean gravidity, proportion of adolescent pregnancies, proportion of pregnant women aged 12 to 19 years, and number of pregnancies at < 18 years were significantly higher among the refugee women ( < 0.001). Rates of antenatal follow-up, double testing, triple testing, gestational diabetes mellitus (GDM) screening, and iron replacement therapy were significantly lower in the refugee group ( < 0.001). The primary Cesarean section rate was significantly lower in the refugee group ( = 0.034). Pregnancies in the refugee group were more complicated, with higher rates of preterm delivery (< 37 weeks), preterm premature rupture of membranes (PPROM), and low birth weight (< 2,500 g) when compared with the control group (4.2% versus 0.7%,  < 0.001; 1.6% versus 0.2%,  = 0.011; and 12% versus 5.8%,  < 0.001, respectively). Low education level (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.5-0.1), and weight gain during pregnancy (OR = 1.7, 95% CI = 0.5-0.1) were found to be significant indicators for preterm birth/PPROM and low birthweight.

CONCLUSION

 Syrian refugees had increased risks of certain adverse obstetric outcomes, including preterm delivery, PPROM, lower birth weight, and anemia. Several factors may influence these findings; thus, refugee women would benefit from more targeted care during pregnancy and childbirth.

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Address: Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey.; Ministry of Health Turkish Public Hospitals Institution Association, Family and Community Medicine, Ankara, Turkey.
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