Maternal Care and Pregnancy Outcomes of Venezuelan and Colombian Refugees

Abstract

Background Ecuador is a major host country for Colombians fleeing violence and Venezuelans escaping a complex humanitarian crisis, many of whom are pregnant women. Methods We used national birth registry data (2018–2020) to compare the maternal care and infant outcomes of Venezuelan and Colombian immigrants with Ecuadorian nationals. Results Venezuelan immigrants had a lower adjusted odds (AOR) for adequate prenatal care (AOR = 0.64;95%CI = 0.62,0.67) but a higher AOR for institutional (AOR = 2.68;95%CI = 1.84,3.93) and C-section delivery (AOR = 1.28;95%CI = 1.23,1.32) and birthing infants who were moderate-late preterm (AOR = 1.12;95%CI = 1.05,1.20), very preterm (AOR = 1.20;95%CI = 1.04,1.40), extremely pre-term (AOR = 1.65;95%CI = 1.27,2.14), low birthweight (LBW) (AOR = 1.11;95%CI = 1.05,1.17), very LBW (AOR = 1.35;95%CI = 1.12,1.62), and extremely LBW (AOR = 1.71;95%CI = 1.36,2.16). Colombians had decreased AORs for adequate prenatal care (AOR = 0.82;95%CI = 0.78,0.87) but increased AORs for institutional (AOR = 2.03;95%CI = 1.19,3.46) and C-section deliveries (AOR = 1.07;95%CI = 1.01,1.13) and birthing infants with moderate-late preterm (AOR = 1.17;95%CI = 1.05,1.30) but not LBW. Discussion The findings underscore the need to address the causes of adequate prenatal care, excess C-sections, and poorer infant outcomes among refugee and immigrant women, especially Venezuelans.

Exploring the impact of Ecuador’s policies on the right to health of Venezuelan migrants during the COVID-19 pandemic: a scoping review

“…Furthermore, the right to health was also affected in other ways. For example, Weigel and Armijos (2023) stated that ‘austerity measures adopted in the pandemic itself are reported to have negatively impacted healthcare services including population access to maternal care in Ecuador’. Likewise, a decrease in seeking and accessing medical attention was reported among migrant populations ( Torres et al , 2022 ; Weigel and Armijos, 2022 ).…”

“…For example, Weigel and Armijos (2023) stated that ‘austerity measures adopted in the pandemic itself are reported to have negatively impacted healthcare services including population access to maternal care in Ecuador’. Likewise, a decrease in seeking and accessing medical attention was reported among migrant populations ( Torres et al , 2022 ; Weigel and Armijos, 2022 ). Moreover, shortage of personnel and medicines, lack of personal protective equipment, including masks, and disruption of medical check-ups, including routine vaccinations for children, were frequent during the pandemic, affecting both nationals and non-nationals in the country.…”

“…There is growing evidence that pandemic measures impacted the health of migrants. For example, Weigel and Armijos (2022) found a decrease in the prevalence of adequate prenatal care from 2018 to 2022, with the largest decline (31%) among Venezuelan migrants ( Weigel and Armijos, 2022 ). Plausible reasons include social distancing measures, lockdown restrictions, shortage of health personnel and a shift in resources to tackle emerging necessities as dictated by the evolution of the pandemic.…”

“…The literature also discussed differences in health outcomes between Venezuelan migrants and Ecuadorian nationals. For example, Venezuelan women have less favourable birth outcomes than Ecuadorians, with higher odds of low birth weight ( Weigel and Armijos, 2022 ). While no proximate risk factors associated with low birth weight have been identified, the literature suggests that stress, violence, untreated pre-existing conditions, lack of formal employment, inadequate housing and exclusion/discrimination can all be possible causes.…”