Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.
J Perinat Med. 2021 Feb 22;49(5):619-623. doi: 10.1515/jpm-2020-0572. Print 2021 Jun 25.
Asylum seekers have been highlighted as a particularly vulnerable group of expectant mothers due to complex medical and psychosocial needs, as well as the difficulties they may face in accessing care. Our aim was to examine if there were differences in the antenatal care and perinatal outcomes for asylum seeking women when compared to age- and ethnicity-matched controls delivering at the same hospital.
Two age- and ethnicity-matched non-asylum seeking controls were identified for each asylum-seeking woman. Electronic patient records were analysed to determine the amount of antenatal care received and neonatal outcomes.
Thirty-four asylum-seeking women were identified who had term born infants. The median number of antenatal care episodes at the delivering hospital was significantly fewer amongst asylum-seeking women compared to controls (three vs. nine, p<0.0001). The median number of antenatal ultrasound examinations at the delivering hospital amongst asylum-seeking women was one (IQR 1-2), compared to three (IQR 3-4) in the controls (p<0.0001). The postnatal length of stay was significantly longer for infants of asylum-seeking women (median three vs. two days, p=0.002). Thirty-seven percent of asylum seeking women but none of the controls required assistance from social services. There was a significant correlation between antenatal and postnatal costs for asylum seeking women (r=0.373, p=0.042), but not for controls (r=0.171, p=0.181).
The increased postnatal length of stay in the infants of asylum seeking mothers may reflect their mother's reduced antenatal care and hence insufficient discharge planning for mothers and infants with increased social needs.
由于复杂的医疗和心理社会需求，以及寻求庇护的孕妇在获得护理方面可能面临的困难，寻求庇护者已成为一个特别脆弱的孕妇群体。我们的目的是研究与在同一家医院分娩的年龄和种族匹配的对照组相比，寻求庇护的妇女在产前护理和围产期结局方面是否存在差异。
为每位寻求庇护的妇女确定了两名年龄和种族匹配的非寻求庇护的对照组。分析电子患者记录以确定接受的产前护理量和新生儿结局。
确定了 34 名寻求庇护的妇女，她们的婴儿足月出生。与对照组相比，寻求庇护的妇女在分娩医院接受的产前护理次数中位数明显较少（三次与九次，p<0.0001）。在分娩医院，寻求庇护的妇女的中位数产前超声检查次数为一次（IQR 1-2），而对照组为三次（IQR 3-4）（p<0.0001）。寻求庇护的妇女的新生儿住院时间明显更长（中位数为三天与两天，p=0.002）。37%的寻求庇护的妇女需要社会服务的帮助，而对照组中没有。寻求庇护的妇女的产前和产后费用之间存在显著相关性（r=0.373，p=0.042），而对照组则没有（r=0.171，p=0.181）。
寻求庇护的母亲的新生儿的产后住院时间延长可能反映了她们的产前护理减少，因此，对于有增加的社会需求的母亲和婴儿，出院计划不足。
