Khadra Maysa M, Suradi Haya H, Amarin Justin Z, El-Bassel Nabila, Kaushal Neeraj, Jaber Ruba M, Al-Qutob Raeda, Dasgupta Anindita
Department of Obstetrics and Gynecology, The University of Jordan School of Medicine, Queen Rania Street, Amman, 11942, Jordan.
The University of Jordan School of Medicine, Amman, Jordan.
Confl Health. 2022 Jun 7;16(1):32. doi: 10.1186/s13031-022-00464-y.
Syrian refugee women face health care disparities and experience worse pregnancy outcomes, including miscarriage. We investigated risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan to identify targets for interventions.
We analyzed data from Women ASPIRE, a cross-sectional study of gendered physical and mental health concerns of 507 Syrian refugee women (≥ 18 years old) living in non-camp settings in Jordan. We recruited women using systematic clinic-based sampling from four clinics. We limited our analyses to women who had a history of pregnancy and whose most recent pregnancy was single, took place in Jordan, and ended in term live birth or miscarriage (N = 307). We grouped the women by the primary outcome (term live birth or miscarriage) and compared the sociodemographic and clinical characteristics of the two groups. We used Pearson's χ test or the Mann-Whitney U test to obtain unadjusted estimates and multivariable binomial logistic regression to obtain adjusted estimates.
The most recent pregnancies of 262 women (85%) ended in term live birth and another 45 (15%) ended in miscarriage. Since crossing into Jordan, 11 women (4%) had not received reproductive health services. Of 35 women who were ≥ 35 years old, not pregnant, and did not want a (or another) child, nine (26%) did not use contraception. Of nine women who were ≥ 35 years old and pregnant, seven (78%) did not plan the pregnancy. The adjusted odds of miscarriage were higher in women who had been diagnosed with thyroid disease (aOR, 5.54; 95% CI, 1.56-19.07), had been of advanced maternal age (aOR, 5.83; 95% CI, 2.02-16.91), and had not received prenatal care (aOR, 36.33; 95% CI, 12.04-129.71). Each additional previous miscarriage predicted an increase in the adjusted odds of miscarriage by a factor of 1.94 (1.22-3.09).
We identified several risk factors for miscarriage in Syrian refugee women living in non-camp settings in Jordan. The risk factors may be amenable to preconception and prenatal care.
叙利亚难民妇女面临医疗保健差异，妊娠结局较差，包括流产。我们调查了居住在约旦非难民营地区的叙利亚难民妇女流产的风险因素，以确定干预目标。
我们分析了“女性渴望健康”（Women ASPIRE）研究的数据，这是一项针对507名居住在约旦非难民营地区（年龄≥18岁）的叙利亚难民妇女的性别身心健康问题的横断面研究。我们通过基于诊所的系统抽样从四个诊所招募妇女。我们将分析限制在有妊娠史且最近一次妊娠为单胎、在约旦发生且以足月活产或流产告终的妇女（N = 307）。我们根据主要结局（足月活产或流产）对妇女进行分组，并比较两组的社会人口学和临床特征。我们使用Pearson卡方检验或Mann-Whitney U检验获得未调整估计值，并使用多变量二项逻辑回归获得调整估计值。
262名妇女（85%）最近一次妊娠以足月活产告终，另外45名（15%）以流产告终。自进入约旦以来，11名妇女（4%）未接受生殖健康服务。在35名年龄≥35岁、未怀孕且不想要（或再要）孩子的妇女中，9名（26%）未采取避孕措施。在9名年龄≥35岁且怀孕的妇女中，7名（78%）未计划此次妊娠。被诊断患有甲状腺疾病的妇女流产的调整后比值较高（调整后比值比[aOR]，5.54；95%置信区间[CI]，1.56 - 19.07），高龄产妇（aOR，5.83；95% CI，2.02 - 16.91），以及未接受产前护理的妇女（aOR，36.33；95% CI，12.04 - 129.71）。既往每增加一次流产，流产调整后比值增加1.94倍（1.22 - 3.09）。
我们确定了居住在约旦非难民营地区的叙利亚难民妇女流产的几个风险因素。这些风险因素可能适合孕前和产前护理。
