Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul

Güngör, Emre Sinan; Seval, Olcay; İlhan, Gülşah; Verit, Fatma Ferda

doi:10.4274/tjod.64022

Cited by 22 publications

(21 citation statements)

References 11 publications

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“…This situation may be due to increased diabetes mellitus (DM) and gestational DM (GDM) prevalence in the Turkish population (18,19) . In two other studies, Demirci et al (10) and Güngör et al (11) reported higher GDM rates for Turkish women when compared with Syrian immigrants.…”

Section: Discussionmentioning

confidence: 91%

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Comparison of the Pregnancy Characteristics and Outcomes Between Syrian Immigrants and Local Turkish Women: Large Cohort Multicenter Study

Kurtulmuş¹,

Güleç²,

Gür³

2021

TERH

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Objective: The aim of the present study is to compare Syrian immigrants and local Turkish women in terms of pregnancy characteristics and its outcomes. Methods: In a large cohort, multicenter, retrospective study, we obtained data from births that occurred in three hospitals in the Metropolitan Municipality of Izmir and Aydin Province between October 1, 2009 and June 1, 2019. We compared 11036 Syrian immigrants and local Turkish women in terms of their demographic features, perinatal, and neonatal outcomes. Results: Pregnant women were significantly younger, and the number of adolescent pregnancies (maternal age<19) was significantly higher in the Syrian immigrant group (p<0.01, and p<0.01, respectively). The number of previous pregnancies was higher among Syrian immigrant pregnant women (p<0.01). Cesarean Section (C/S) and interventional delivery rates were higher in Turkish pregnant women, and C/S delivery indications were significantly different between the groups (p<0.05, and p<0.01, respectively). Preterm birth rates (<37 gestational weeks) were higher in the Syrian immigrants, whereas the rates of low birth weight (LBW) (<2500 gr) were higher in the Turkish women (p<0.05, and p<0.05, respectively). Also, the mean newborn birth weight and head circumference of the newborns were higher in the Turkish women, whereas the birth length of newborns was higher in the Syrian immigrants (p<0.01, p<0.01, and p<0.01, respectively). Conclusion: In the present study, compared to local Turkish pregnant women, pregnancy characteristics and the perinatal outcomes of the Syrian immigrant women and their neonates had different characteristics. Moreover, the types and indications of delivery of Syrian immigrants differed from those of Turkish pregnant women. The findings of our large cohort study can contribute to the improvement of health policies in Turkey and other countries hosting Syrian immigrants.

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Section: Discussionmentioning

confidence: 91%

“…Numerous studies exist in the literature that compare Syrian immigrants, and local citizens in terms of pregnancy outcomes (8)(9)(10)(11)(12)(13) . To our knowledge, this multicenter study has the largest-scale cohort study performed up to now.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Pregnancy Characteristics and Outcomes Between Syrian Immigrants and Local Turkish Women: Large Cohort Multicenter Study

Kurtulmuş¹,

Güleç²,

Gür³

2021

TERH

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“…Additionally, while 3.1% of the babies of Syrian refugees had low birth weights, this rate was 7.7% among Turkish citizens; these rates were not significantly different. Although some Turkish studies in the literature support these findings [ 11 , 17 ], the available scientific evidence shows that being a refugee constitutes a disadvantage for neonatal weight [ 8 , 9 , 15 , 18 ]. The Republic of Turkey provides free health services to Syrian refugees and makes it easier for them to reach health resources.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Characteristics and Pregnancy and Neonatal Outcomes Between Turkish Citizens and Syrian Refugees with High-Risk Pregnancies

Sayılı

Ozgur

Gazanfer

et al. 2021

J Immigrant Minority Health

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Refugee women experience more negative pregnancy and neonatal outcomes, such as low birth weight and preterm birth. The aim of the present study was to compare the clinical characteristics and pregnancy and neonatal outcomes between Turkish citizens and Syrian refugees with high-risk pregnancies. This prospective cohort study was conducted between March and December 2020 in Sanliurfa, Turkey. The maternal characteristics and pregnancy and neonatal outcomes were compared between the two groups. In this study, a total of 302 high-risk pregnant women (233 Turkish citizens and 69 Syrian refugees) were included. Parity and pregnancy spacing shorter than 2 years were significantly higher in Syrian refugees. Age, previous abortion or miscarriage and rates of cesarean section (C/S) were significantly higher in Turkish citizens. The live birth (Turkish: 94.8% vs Syrian: 92.8%), preterm birth (Turkish: 10% vs Syrian: 9.4%), low birth weight (Turkish: 7.7% vs Syrian: 3.1%) rates and birth weight (g) (Turkish: 3097.5 ± 501.3 g; Syrian: 2980.2 ± 395.0 g) were not significantly different between Turkish citizens and Syrian refugees with high-risk pregnancy. Similar pregnancy and neonatal outcomes could be attributed to the Syrians receiving adequate and free maternity care, similar to the Turkish citizens.

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“…Eleven studies included preeclampsia as an outcome measure. [13][14][15][16][17][18][19][20][21][22][23] All but one 16 found a lower prevalence in the refugee population than in the native population, with point estimates ranging from 1.67% (vs 5% among native women) in Erenel et al, 20 to 3.85% (vs 3.9% among native women) in Demirci et al 16,19,20,22 The studies that reported relative risk (OR or RR), all showed refugees to have a lower risk of preeclampsia during pregnancy, with risk estimates ranging between 0.65 and 0.81. [13][14][15]17,18,21,23…”

Section: Preeclampsiamentioning

confidence: 99%

“…Gungör et al reported on infectious diseases in general and did not define their outcome "maternal infectious diseases" in any detail, which makes their data very difficult to interpret. 22 HIV was the only infection separately addressed in the included studies. The results in Wanigarantne et al show a 10-fold increased risk of HIV among the refugee population.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

Pregnancy complications among refugee women: A systematic review

Harakow

Hvidman

Wejse

et al. 2021

Acta Obstet Gynecol Scand

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Introduction Pregnancy is a time of increased vulnerability for women. Women of refugee background may be further challenged in pregnancy due to a complex series of physical, psychological and social factors. Previous studies show ambiguous results, with some showing increased the risk of prenatal complications in refugees compared with their native counterparts, whereas other studies report the opposite. With the current steep rise in the number of refugees and displaced persons worldwide, research is important to understand whether pregnancy disparities between this population and their native counterparts exist, and the causes. This systematic literature review aims to find out whether refugee women have a higher prevalence of adverse pregnancy outcomes and prenatal infections compared with native women. Material and methods We conducted a literature search in the databases PubMed and Embase, supplemented with screening of reference lists and citations for relevant literature. We included studies published in English reporting risk of preeclampsia, spontaneous abortion and stillbirths, preterm birth, preterm prelabor rupture of membranes (PPROM) and adverse prenatal infectious diseases in women of refugee status. PROSPERO registration CRD42020205628. Results We identified 19 articles eligible for inclusion: 12 were cross‐sectional, six were cohort studies and one was a case‐control study. The most frequently reported outcome in the literature was preterm birth (reported in 16 of the studies) and preeclampsia (reported in 11 of the studies). Refugees had increased risk of stillbirth (reported relative risk ranging from 1.20 to 2.24) and spontaneous abortion (reported relative risk ranging from 1.56 to 1.58), when compared with native women and a decreased risk of preeclampsia (reported relative risk ranging from 0.65 to 0.81). Conclusions The small number of articles eligible for inclusion in the review highlights the lack of research and knowledge on refugee health during pregnancy. Further research is required to understand and reduce disparities in pregnancy outcomes between refugee and non‐refugee women.

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Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul

Cited by 22 publications

References 11 publications

Comparison of the Pregnancy Characteristics and Outcomes Between Syrian Immigrants and Local Turkish Women: Large Cohort Multicenter Study

Comparison of the Pregnancy Characteristics and Outcomes Between Syrian Immigrants and Local Turkish Women: Large Cohort Multicenter Study

Comparison of Clinical Characteristics and Pregnancy and Neonatal Outcomes Between Turkish Citizens and Syrian Refugees with High-Risk Pregnancies

Pregnancy complications among refugee women: A systematic review

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