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Open Access
CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(11): 673-679
DOI: 10.1055/s-0038-1673427
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Sule Ozel
1   Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey
,
Selen Yaman
1   Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey
,
Hatice Kansu-Celik
1   Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey
,
Necati Hancerliogullari
1   Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey
,
Nurgul Balci
2   Ministry of Health Turkish Public Hospitals Institution Association, Family and Community Medicine, Ankara, Turkey
,
Yaprak Engin-Ustun
1   Department of Obstetrics and Gynecology, University of Health Science, Zekai Tahir Burak Woman's Health, Education and Research Hospital, Ankara, Turkey
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Publikationsverlauf

21. Mai 2018

26. Juli 2018

Publikationsdatum:
11. Oktober 2018 (online)

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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 (p < 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 (p < 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 (p < 0.001). The primary Cesarean section rate was significantly lower in the refugee group (p = 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%, p < 0.001; 1.6% versus 0.2%, p = 0.011; and 12% versus 5.8%, p < 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.

Keywords

Syrian Refugees - immigrants - obstetric outcomes - neonatal outcomes - antenatal care

Contributions

Sule Ozel: Substantial contributions to conception and design; data collection or analysis; interpretation of data; writing of the article or critical review of the intellectual content, and final approval of the version to be published. Selen Yaman: Design, data collection and analysis, writing of the article or critical review of the intellectual content. Hatice Kansu-Celik: Substantial contributions to conception and design, interpretation of data, and writing of the article or critical review of the intellectual content. Necati Hancerliogullari: Data collection, analysis, and interpretation of data. Nurgul Balci: Substantial contributions to conception and design, data collection and analysis. Yaprak Engin-Ustun: Writing of the article or critical review of the intellectual content, and final approval of the version to be published.