Neonatal outcomes in Syrian and other refugees treated in a tertiary hospital in Turkey

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Abstract

Background/aim

Turkey accepts refugees from many countries, principally Syria. More than 2.7 million refugees live in Turkey.We evaluated the neonatal outcomes of refugees.

Materials and methods

We retrospectively reviewed the clinical and demographic characteristics of refugee infants born in our hospital between August 2013 and September 2016.

Results

Refugees (718 Syrian, 136 Iraqi, 32 Afghani, and 21 of other nationalities) accounted for 907 of 49,413 births. The mean refugee maternal age was lower than that of Turkish women, whereas the gestational age (GA) and birthweight were similar. Refugees required fewer cesarean sections but exhibited greater small- and large-for-GA rates (P < 0.05). Refugee and Turkish infant mortality rates did not differ significantly (0.8 vs. 0.4%). Eighty-nine (12.3%) refugee neonates and 6682 (13.5%) Turkish neonates were admitted to our neonatal intensive care unit (NICU). Jaundice and perinatal asphyxia were significantly more common in refugees, whereas respiratory distress syndrome, GA ≤32 weeks, and infant birthweight <2000 g were more common in Turkish infants. The total NICU admission cost of approximately 450,000 USD was paid by the Turkish government.

Conclusion

The numbers of refugees and refugee births continue to grow. The Turkish people and government have provided medical, social, and economic support to date; international assistance is needed.

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Most cited references 11

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Assessment of reproductive health and violence against women among displaced Syrians in Lebanon

Amelia Reese Masterson, Jinan Usta, Jhumka Gupta … (2014)

Background The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. Methods We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. Results We interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. Conclusions This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence.

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An assessment of antenatal care among Syrian refugees in Lebanon

Matthew Benage, P Gregg Greenough, Patrick Vinck … (2015)

Background After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. Methods A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. Results In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1–2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Conclusions Standards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.

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Clinical characteristics and pregnancy outcomes of Syrian refugees: a case–control study in a tertiary care hospital in Istanbul, Turkey

Hakan Erenel, Begum Aydogan Mathyk, Veysel Sal … (2017)

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Author and article information

Journal

Journal ID (nlm-ta): Turk J Med Sci

Journal ID (iso-abbrev): Turk J Med Sci

Title: Turkish Journal of Medical Sciences

Publisher: The Scientific and Technological Research Council of Turkey

ISSN (Print): 1300-0144

ISSN (Electronic): 1303-6165

Publication date Collection: 2019

Publication date (Electronic): 18 June 2019

Volume: 49

Issue: 3

Pages: 815-820

Affiliations

[1 ] Division of Neonatology, Department of Pediatrics, University of Health Sciences,Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital, Ankara Turkey

[2 ] Department of Obstetrics and Gynecology, University of Health Sciences,Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital, Ankara Turkey

[3 ] Division of Neonatology, Department of Pediatrics, School of Medicine, Yıldırım Beyazıt University, Ankara Turkey

Author notes

* To whom correspondence should be addressed. E-mail: istemihancelik@ 123456gmail.com

CONFLICT OF INTEREST:

none declared

Author information

İstemi Han ÇELİK https://orcid.org/0000-0002-2952-8154

Zehra ARSLAN https://orcid.org/0000-0002-1939-405X

Dilek ULUBAŞ IŞIK https://orcid.org/0000-0001-9937-4624

Ömer Lütfi TAPISIZ https://orcid.org/0000-0002-7128-8086

Leyla MOLLAMAHMUTOĞLU https://orcid.org/0000-0003-4904-3303

Ahmet Yağmur BAŞ https://orcid.org/0000-0002-1329-2167

Nihal DEMİREL https://orcid.org/0000-0003-2044-2212

Article

DOI: 10.3906/sag-1806-86

PMC ID: 7018309

PubMed ID: 31195786

SO-VID: 30dd495b-97fb-469a-918e-874fd9d5ffb3

License:

This article is distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.

Neonatal outcomes in Syrian and other refugees treated in a tertiary hospital in Turkey

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Abstract

Background/aim

Materials and methods

Results

Conclusion

Related collections

Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 11

Assessment of reproductive health and violence against women among displaced Syrians in Lebanon

An assessment of antenatal care among Syrian refugees in Lebanon

Clinical characteristics and pregnancy outcomes of Syrian refugees: a case–control study in a tertiary care hospital in Istanbul, Turkey

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