Said Muna, Osayande Itohan, Badejo Okikiolu, Banke-Thomas Aduragbemi
School of Human Sciences, University of Greenwich, London, UK.
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Matern Health Neonatol Perinatol. 2025 Jun 3;11(1):14. doi: 10.1186/s40748-025-00210-1.
The enduring conflict in Somalia has precipitated significant humanitarian crises, including severely weakened health systems and poor health indicators. The situation has led to almost two million Somalis living abroad, often as refugees or asylum seekers in more high-resource settings in the Global North. To understand outcomes of care of pregnant women and their babies in host countries, this systematic review and meta-analysis aims to synthesise existing evidence on adverse maternal and perinatal outcomes among Somali migrant women compared to host populations.
We conducted a comprehensive search across multiple electronic databases, including PubMed, Scopus, CINAHL Plus, and the Directory of Open Access Journals, using tailored keyword combinations. No language or date restrictions were applied, and the search concluded on June 30, 2024. Following data extraction and quality assurance using the STROBE Checklist, we conducted a meta-analysis for outcomes with sufficient data, using a random-effects model to account for heterogeneity across populations. Subgroup analyses were conducted by host country, with heterogeneity assessed using I and τ statistics. Potential publication bias was evaluated through Egger's test and funnel plots. The results provide pooled estimates of maternal and perinatal outcomes.
Across all databases, 116 articles were retrieved, with 17 meeting the eligibility criteria. From these articles, pregnancy-related data from 1978 to 2018 on 55,119 Somali migrant women and 5,190,459 women from the host population was extracted. Somali migrant women, compared to host populations, had significantly increased odds of emergency caesarean section (CS) (pooled OR 2.54, 95%CI: 2.22-2.86), non-progressing/induced labour (pooled OR 1.25, 95%CI: 1.19-1.31). Their babies had higher odds of small for gestational age (SGA) (pooled OR 2.03, 95%CI: 1.89-2.17), neonatal morbidity (pooled OR 1.51, 95%CI: 1.40-1.61), and neonatal mortality (pooled OR 1.39, 95%CI: 1.25-1.54). Conversely, Somali migrant women had lower odds of assisted instrumental delivery (OR 0.72, 95%CI: 0.66-0.78), post-partum depression (OR 0.27, 95% CI: 0.12-0.63), preterm birth (OR 0.92, 95%CI: 0.88-0.96), and low birth weight (OR 0.87, 95% CI: 0.80-0.94) compared to host populations.
Significant disparities in maternal and perinatal outcomes between Somali migrant women and host populations exist. Though more research is needed, available evidence points to the need for more culturally aware obstetric services that address the specific needs of Somali migrant women.
索马里长期的冲突引发了严重的人道主义危机，包括卫生系统严重削弱和健康指标不佳。这种情况导致近200万索马里人生活在国外，他们在全球北方资源更丰富的地区往往是难民或寻求庇护者。为了解侨居国孕妇及其婴儿的护理结果，本系统评价和荟萃分析旨在综合现有证据，比较索马里移民妇女与侨居国人口中不良孕产妇和围产期结局的情况。
我们使用定制的关键词组合，对多个电子数据库进行了全面检索，包括PubMed、Scopus、CINAHL Plus和开放获取期刊目录。未设置语言或日期限制，检索于2024年6月30日结束。在使用STROBE清单进行数据提取和质量保证后，我们对有足够数据的结局进行了荟萃分析，使用随机效应模型来考虑不同人群间的异质性。按侨居国进行亚组分析，使用I和τ统计量评估异质性。通过Egger检验和漏斗图评估潜在的发表偏倚。结果提供了孕产妇和围产期结局的合并估计值。
在所有数据库中，共检索到116篇文章，其中17篇符合纳入标准。从这些文章中，提取了1978年至2018年55119名索马里移民妇女和5190459名侨居国妇女的妊娠相关数据。与侨居国人口相比，索马里移民妇女急诊剖宫产（CS）的几率显著增加（合并OR 2.54，95%CI：2.22 - 2.86），产程无进展/引产（合并OR 1.25，95%CI：1.19 - 1.31）。她们的婴儿小于胎龄（SGA）、新生儿发病率（合并OR 1.51，95%CI：1.40 - 1.61）和新生儿死亡率（合并OR 1.39，95%CI：1.25 - 1.54）的几率更高。相反，与侨居国人口相比，索马里移民妇女辅助器械分娩（OR 0.72，95%CI：0.66 - 0.78）、产后抑郁症（OR 0.27，95%CI：0.12 - 0.63）、早产（OR 0.92，95%CI：0.88 - 0.96）和低出生体重（OR 0.87，95%CI：0.80 - 0.94）的几率较低。
索马里移民妇女与侨居国人口在孕产妇和围产期结局方面存在显著差异。尽管还需要更多研究，但现有证据表明需要提供更具文化意识的产科服务，以满足索马里移民妇女的特殊需求。
