Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States.
Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
Front Public Health. 2023 May 9;11:1157098. doi: 10.3389/fpubh.2023.1157098. eCollection 2023.
Globally, refugee women continue to face higher maternity-related risks from preventable complications during pregnancy and childbirth, partly due to high health care costs, unfamiliarity with the healthcare system, language barriers, and discrimination. Nevertheless, there is still a paucity of literature that evaluates the available evidence in the US. This scoping review delineated the body of literature on maternal health among refugee women resettled in the US in order to identify knowledge gaps in the literature and highlight future research priorities and directions for maternal health promotion.
Electronic databases were searched in PubMed, CINAHL, PsycINFO, and EMBASE from inception through July 2021. We included all peer-reviewed study designs; qualitative, quantitative, and mixed method if they reported on refugee women's perinatal health experiences and outcomes in the US.
A total of 2,288 records were identified, with 29 articles meeting the inclusion criteria. Refugee women tend to initiate prenatal care late and have fewer prenatal care visits compared to women born in the US. Some of them were reluctant to get obstetric interventions such as labor induction and cesarean delivery. Despite numerous risk factors, refugee women had generally better maternal health outcomes. Studies have also highlighted the importance of health care providers' cultural competency and sensitivity, as well as the potential role of community health workers as a bridge between refugee women and health care providers.
The scoping review emphasizes the need for early prenatal care initiation and more frequent prenatal care visits among refugee women. Furthermore, more needs to be done to mitigate resistance to obstetric interventions and mistrust. The mechanism by which healthy migrant effects occur could be better understood, allowing protective factors to be maintained throughout the resettlement and acculturation process. The scoping review identifies critical gaps in the literature, such as the underrepresentation of different ethnic groups of refugee women in refugee maternal studies in the US. Since this invisibility may indicate unspoken and unaddressed needs, more attention should be paid to underrepresented and understudied groups of refugee women in order to achieve health equity for all.
在全球范围内，由于高医疗保健费用、对医疗保健系统不熟悉、语言障碍和歧视等原因，难民妇女在妊娠和分娩期间仍然面临更高的与母婴相关的可预防并发症风险。然而，在美国，评估相关文献的证据仍然很少。本范围界定性综述阐述了关于在美国重新安置的难民妇女的产妇健康的文献，以确定文献中的知识空白，并强调促进产妇健康的未来研究重点和方向。
从建库至 2021 年 7 月，在 PubMed、CINAHL、PsycINFO 和 EMBASE 电子数据库中进行检索。我们纳入了所有同行评审的研究设计；定性、定量和混合方法，如果它们报告了美国难民妇女的围产期健康体验和结局。
共确定了 2288 条记录，其中 29 篇文章符合纳入标准。与在美国出生的妇女相比，难民妇女往往较晚开始产前护理，产前护理次数也较少。其中一些人不愿意接受产科干预，如引产和剖宫产。尽管存在许多风险因素，但难民妇女的产妇健康结局总体上较好。研究还强调了医疗保健提供者的文化能力和敏感性的重要性，以及社区卫生工作者作为难民妇女和医疗保健提供者之间桥梁的潜在作用。
本范围界定性综述强调了难民妇女需要尽早开始产前护理并增加产前护理次数。此外，需要采取更多措施来减轻对产科干预措施的抵制和不信任。可以更好地理解健康移民效应发生的机制，以便在重新安置和文化适应过程中保持保护因素。该范围界定性综述确定了文献中的关键空白，例如美国的难民产妇研究中代表性不足的不同族裔群体的难民妇女。由于这种隐形现象可能表明存在未被提及和未被解决的需求，因此应该更加关注代表性不足和研究不足的难民妇女群体，以实现所有人的健康公平。
