ObjectivesThis study aims to assess whether the characteristics, management and outcomes of women varied between Syrian and Palestinian refugees, migrant women of other nationalities and Lebanese women giving birth at a public tertiary centre in Beirut, Lebanon.MethodsThis was a secondary data analysis of routinely collected data from the public Rafik Hariri University Hospital (RHUH) between January 2011 and July 2018. Data were extracted from medical notes using text mining machine learning methods. Nationality was categorised into Lebanese, Syrian, Palestinian and migrant women of other nationalities. The main outcomes were diabetes, pre-eclampsia, placenta accreta spectrum, hysterectomy, uterine rupture, blood transfusion, preterm birth and intrauterine fetal death. Logistic regression models estimated the association between nationality and maternal and infant outcomes, and these were presented using ORs and 95% CIs.Results17 624 women gave birth at RHUH of whom 54.3% were Syrian, 39% Lebanese, 2.5% Palestinian and 4.2% migrant women of other nationalities. The majority of women had a caesarean section (73%) and 11% had a serious obstetric complication. Between 2011 and 2018, there was a decline in the use of primary caesarean section (caesarean section performed for the first time) from 7% to 4% of births (p<0.001). The odds of preeclampsia, placenta abruption and serious complications were significantly higher for Palestinian and migrant women of other nationalities compared to Lebanese women, but not for Syrian women. Very preterm birth was higher for Syrians (OR: 1.23, 95% CI: 1.08 to 1.40) and migrant women of other nationalities (OR: 1.51, 95% CI: 1.13 to 2.03) compared to Lebanese women.ConclusionSyrian refugees in Lebanon had similar obstetric outcomes compared to the host population, except for very preterm birth. However, Palestinian women and migrant women of other nationalities appeared to have worse pregnancy complications than the Lebanese women. There should be better healthcare access and support for migrant populations to avoid severe complications of pregnancy.
Acute fatty liver disease of pregnancy (AFLP) is a rare life‐threatening medical emergency unique to pregnancy. It is characterized by progressive microvesicular fatty infiltration of maternal hepatocytes, but the exact etiology has yet to be elucidated. AFLP typically manifests in late third trimester or immediately postpartum and seldom during second trimester. Prompt delivery, irrespective of gestational age or severity, is crucial for arresting the insult and permitting recovery. We hereby report a 21‐year‐old Lebanese second‐gravid woman at 20 weeks' gestation diagnosed with AFLP depending on clinical features and compatible laboratory studies (score of 8 on Swansea criteria), in spite of early occurrence. A review and analysis of early AFLP (second trimester) compared to late (third trimester) was also presented. AFLP appearing during second trimester is as serious as the disease manifesting in late third trimester, with similar diagnostic difficulties, less association with hypertension, but with greater hesitation of obstetricians to affect prompt delivery and higher adverse perinatal outcome due to added effect of premature delivery in second trimester.
To estimate, for Lebanon, the financial benefit of screening for preterm pre-eclampsia (PE) at 11-13 weeks gestation combining risk factors with mean arterial pressure and maternal serum placental growth factor. Preterm PE cases delivered during 2010-2018 at Rafik Hariri University Hospital were identified from electronic records. Manual nursing notes were reviewed to confirm the diagnosis using international criteria. For each case, adverse maternal and infant events were noted and billing information extracted. A series of 1000 non-PE pregnancies were identified and billing information recorded. Published screening detection rates for a 10% false-positive rate and the proportion prevented by aspirin prophylaxis were applied to estimate the reduced cost following screening. There were a total of 17,131 deliveries including 486 (2.84%) PE and 223 (1.30%) preterm PE cases. The caesarean section rate was substantially higher for preterm PE (74%) than non-PE deliveries (36%) and 76% of infants were admitted to the Newborn Intensive Care Unit, where the average stay was 32, 21 and 8 days for deliveries before 32, 32-33 and 34-36 weeks respectively. The total cost of maternal and infant care for preterm PE was $881,206 and the average cost of an unaffected delivery $599. It was estimated that following screening the saving in treatment costs including aspirin would have been $431,665, which is $24 per woman delivering at the hospital over the nine year period. The financial savings are more than sufficient to pay for the screening test in those who are screen-positive.
Background: The primary aim of this study was to measure the prevalence of pregnant women who fast during Ramadan. The secondary outcome was their beliefs and motivations regarding fasting during Ramadan in addition to the consequences of fasting on maternal and neonatal outcome.Methods: A retrospective review of pregnant patients aged between 18-45 years who presented for antenatal care in the private clinic in Beirut, Lebanon during or after the month of Ramadan between 2010 and 2019 was performed.Results: A total of 502 pregnant patients were included in the study, of which 426 (84.9%) fasted during Ramadan and 76 (15.1%) did not fast at all. Of those who fasted, 148 (34.7%) fasted between 1 and 15 days while 278 (65.3%) fasted more than 15 days. Multiparous and non-Lebanese women had significantly higher rate of fasting compared to primiparous and Lebanese women. Adherence to fasting was associated with the spiritual environment that accompanies the month of Ramadan while non-adherence was mainly related to the fear from adverse effects on the mother and fetus. Fasting was not significantly associated with maternal complications or decreased neonatal birth weight.Conclusions: The present study showed that Ramadan fasting is important to pregnant Muslim women. This was manifested by the relatively high rate of fasting even in summer and spring seasons. Understanding the beliefs and motivations of pregnant women would provide valuable insight to physicians to appropriately advise these women without compromising the maternal or fetal well-being.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.