Ozel Sule, Yaman Selen, Kansu-Celik Hatice, Hancerliogullari Necati, Balci Nurgul, Engin-Ustun Yaprak
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.
Rev Bras Ginecol Obstet. 2018 Nov;40(11):673-679. doi: 10.1055/s-0038-1673427. Epub 2018 Oct 11.
The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women.
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.
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.
本研究旨在分析和比较叙利亚难民与土耳其族裔女性的产科和新生儿结局。
回顾性观察研究。本研究纳入了576名叙利亚难民和576名土耳其族裔女性，于2015年1月至2015年12月在土耳其安卡拉的一家三级产科培训医院进行。比较了两组的人口统计学特征、产科和新生儿结局。主要结局是两组之间的妊娠结局和剖宫产率。结果：难民组的平均年龄显著更低（<0.001）。难民女性的平均妊娠次数、青少年妊娠比例、12至19岁孕妇比例以及<18岁时的妊娠次数显著更高（<0.001）。难民组的产前检查、双联检测、三联检测、妊娠期糖尿病（GDM）筛查和铁剂替代治疗率显著更低（<0.001）。难民组的初次剖宫产率显著更低（=0.034）。与对照组相比，难民组的妊娠更复杂，早产（<37周）、胎膜早破（PPROM）和低出生体重（<2500g）的发生率更高（分别为4.2%对0.7%，<0.001；1.6%对0.2%，=0.011；12%对5.8%）。低教育水平（优势比[OR]=1.7，95%置信区间[CI]=0.5 - 0.1）和孕期体重增加（OR=1.7，95%CI=0.5 - 0.1）被发现是早产/PPROM和低出生体重的重要指标。
叙利亚难民出现某些不良产科结局的风险增加，包括早产、PPROM、低出生体重和贫血。若干因素可能影响这些结果；因此，难民女性在孕期和分娩期间将受益于更有针对性的护理。
