Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Abstract

Background: Immigration into Europe has reached an all-time high. Provision of coordinated healthcare, especially to refugee women that are at increased risk for adverse pregnancy outcomes, is a challenge for receiving health care systems. Methods: We assessed pregnancy rates and associated primary healthcare needs in three refugee cohorts in Northern Germany during the current crisis. Results: Out of n = 2911 refugees, 18.0% were women of reproductive age, and 9.1% of these were pregnant. Pregnancy was associated with a significant, 3.7-fold increase in primary health care utilization. Language barrier and cultural customs impeded healthcare to some refugee pregnant women. The most common complaints were demand for pregnancy checkup without specific symptoms (48.6%), followed by abdominal pain or urinary tract infections (in 11.4% of cases each). In 4.2% of pregnancies, severe complications such as syphilis or suicide attempts occurred. Discussion: We present data on pregnancy rates and pregnancy associated medical need in three current refugee cohorts upon arrival in Germany. Healthcare providers should be particularly aware of the requirements of pregnant migrants and should adapt primary caretaking strategies accordingly.

Referrals to secondary care in an outpatient primary care walk-in clinic for refugees in Germany: results from a secondary data analysis based on electronic medical records

“…For example, a different study, also located in northern Germany, reported only 9% of the refugee women in this age group. 32 The higher rates in our study might be explained by the fact that our ratio is based on women using healthcare and not on the general female refugee population of reproductive age. Other studies based on the general refugee population and/or including screening measures reported comparable differences to our study.…”

“…Pregnant refugees are a vulnerable patient group with increased healthcare utilisation. 32 Despite the fact that they were allowed to use gynaecologists, midwives and nursing care, 14 it was de facto hardly possible to get this kind of support during the specific situation of 2015–2016. In order to prevent adverse health outcomes, 41 care for pregnant women was included in the primary care for refugees in our walk-in clinic.…”

Healthcare Utilization in a Large Cohort of Asylum Seekers Entering Western Europe in 2015

“…The provision of full time primary medical care at an onsite ward of the asylum seeker residence—with patient specific documentation of visit time and frequency—was unique to the here presented cohort and ideal for the conducted analysis. In other cohorts thus far analyzed by our team, similar analysis is hampered by limited data extraction of residence time and medical records that could only be obtained by a proportion of asylum seekers or were collected in a different fashion than in the here described cohort [ 15 , 16 , 17 , 19 , 20 , 23 , 24 ]. Currently, however, we aim at harmonizing and analyzing further large asylum seeker cohorts of a similar kind to see whether our results can be confirmed in a greater specimen of migrants entering Western Europe during the current crisis.…”

Factors Influencing the Frequency of Airway Infections in Underage Refugees: A Retrospective, Cross Sectional Study

“…Data on primary medical care provision from two migrant reception centers in Celle and Friedland, Germany were included into this analysis. The study cohorts consisted of n = 3104 refugees housed in Celle between September 2015 and June 2016 (parts of this cohort have been previously described [ 8 ]) and n = 7327 refugees housed in Friedland between August 2017 and January 2019 (parts of this cohort were previously described [ 9 ]). Refugees were accommodated in these reception facilities for a transitional period of a few weeks up to several months.…”