Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis
Abstract Background With more than 20,000 asylum seekers arriving every year, healthcare for this population has become an important issue. Pregnant asylum seekers seem to be at risk of poor pregnancy outcomes. This study aimed to assess the difference in pregnancy outcomes between asylum seekers an...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-02985-x |
| _version_ | 1818400746228416512 |
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| author | A. E. H. Verschuuren I. R. Postma Z. M. Riksen R. L. Nott E. I. Feijen-de Jong J. Stekelenburg |
| author_facet | A. E. H. Verschuuren I. R. Postma Z. M. Riksen R. L. Nott E. I. Feijen-de Jong J. Stekelenburg |
| author_sort | A. E. H. Verschuuren |
| collection | DOAJ |
| description | Abstract Background With more than 20,000 asylum seekers arriving every year, healthcare for this population has become an important issue. Pregnant asylum seekers seem to be at risk of poor pregnancy outcomes. This study aimed to assess the difference in pregnancy outcomes between asylum seekers and the local Dutch population and to identify potential substandard factors of care. Methods Using a retrospective study design we compared pregnancy outcomes of asylum-seeking and Dutch women who gave birth in a northern region of the Netherlands between January 2012 and December 2016. The following data were compared: perinatal mortality, maternal mortality, gestational age at delivery, preterm delivery, birth weight, small for gestational age children, APGAR score, intrauterine foetal death, mode of delivery and the need for pain medication. Cases of perinatal mortality in asylum seekers were reviewed for potential substandard factors. Results A total of 344 Asylum-seeking women and 2323 Dutch women were included. Asylum seekers had a higher rate of perinatal mortality (3.2% vs. 0.6%, p = 0.000) including a higher rate of intrauterine foetal death (2.3% vs. 0.2%, p = 0.000), higher gestational age at birth (39 + 4 vs. 38 + 6 weeks, p = 0.000), labour was less often induced (36.9 vs. 43.8, p = 0.016), postnatal hospitalization was longer (2.24 vs. 1.72 days p = 0.006) and they received more opioid analgesics (27.3% vs. 22%, p = 0.029). Babies born from asylum-seeking women had lower birth weights (3265 vs. 3385 g, p = 0.000) and were more often small for gestational age (13.9% vs. 8.4%, p = 0.002). Multivariate analysis showed that the increased risk of perinatal mortality in asylum-seeking women was independent of parity, birth weight and gestational age at birth. Review of the perinatal mortality cases in asylum seekers revealed possible substandard factors, such as late initiation of antenatal care, missed appointments because of transportation problems, not recognising alarm symptoms, not knowing who to contact and transfer to other locations during pregnancy. Conclusion Pregnant asylum seekers have an increased risk of adverse pregnancy outcomes. More research is needed to identify which specific risk factors are involved in poor perinatal outcomes in asylum seekers and to identify strategies to improve perinatal care for this group of vulnerable women. |
| first_indexed | 2024-12-14T07:41:28Z |
| format | Article |
| id | doaj.art-529375f26fee4aeca02c6685706edd74 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-14T07:41:28Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-529375f26fee4aeca02c6685706edd742022-12-21T23:11:02ZengBMCBMC Pregnancy and Childbirth1471-23932020-05-0120111010.1186/s12884-020-02985-xPregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysisA. E. H. Verschuuren0I. R. Postma1Z. M. Riksen2R. L. Nott3E. I. Feijen-de Jong4J. Stekelenburg5Department of Obstetrics and Gynaecology and Department of Health Sciences, Global Health, University Medical Center Groningen/University of GroningenDepartment of Obstetrics and Gynaecology and Department of Health Sciences, Global Health, University Medical Center Groningen/University of GroningenRefaja ziekenhuis StadskanaalNew LifeDepartment of General Practice & Elderly Medicine, University Medical Center Groningen, University of GroningenDepartment of Obstetrics and Gynaecology and Department of Health Sciences, Global Health, University Medical Center Groningen/University of GroningenAbstract Background With more than 20,000 asylum seekers arriving every year, healthcare for this population has become an important issue. Pregnant asylum seekers seem to be at risk of poor pregnancy outcomes. This study aimed to assess the difference in pregnancy outcomes between asylum seekers and the local Dutch population and to identify potential substandard factors of care. Methods Using a retrospective study design we compared pregnancy outcomes of asylum-seeking and Dutch women who gave birth in a northern region of the Netherlands between January 2012 and December 2016. The following data were compared: perinatal mortality, maternal mortality, gestational age at delivery, preterm delivery, birth weight, small for gestational age children, APGAR score, intrauterine foetal death, mode of delivery and the need for pain medication. Cases of perinatal mortality in asylum seekers were reviewed for potential substandard factors. Results A total of 344 Asylum-seeking women and 2323 Dutch women were included. Asylum seekers had a higher rate of perinatal mortality (3.2% vs. 0.6%, p = 0.000) including a higher rate of intrauterine foetal death (2.3% vs. 0.2%, p = 0.000), higher gestational age at birth (39 + 4 vs. 38 + 6 weeks, p = 0.000), labour was less often induced (36.9 vs. 43.8, p = 0.016), postnatal hospitalization was longer (2.24 vs. 1.72 days p = 0.006) and they received more opioid analgesics (27.3% vs. 22%, p = 0.029). Babies born from asylum-seeking women had lower birth weights (3265 vs. 3385 g, p = 0.000) and were more often small for gestational age (13.9% vs. 8.4%, p = 0.002). Multivariate analysis showed that the increased risk of perinatal mortality in asylum-seeking women was independent of parity, birth weight and gestational age at birth. Review of the perinatal mortality cases in asylum seekers revealed possible substandard factors, such as late initiation of antenatal care, missed appointments because of transportation problems, not recognising alarm symptoms, not knowing who to contact and transfer to other locations during pregnancy. Conclusion Pregnant asylum seekers have an increased risk of adverse pregnancy outcomes. More research is needed to identify which specific risk factors are involved in poor perinatal outcomes in asylum seekers and to identify strategies to improve perinatal care for this group of vulnerable women.http://link.springer.com/article/10.1186/s12884-020-02985-xAsylum seekersPregnancy outcomesPerinatal mortalityVulnerable womenSubstandard factors |
| spellingShingle | A. E. H. Verschuuren I. R. Postma Z. M. Riksen R. L. Nott E. I. Feijen-de Jong J. Stekelenburg Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis BMC Pregnancy and Childbirth Asylum seekers Pregnancy outcomes Perinatal mortality Vulnerable women Substandard factors |
| title | Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis |
| title_full | Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis |
| title_fullStr | Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis |
| title_full_unstemmed | Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis |
| title_short | Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis |
| title_sort | pregnancy outcomes in asylum seekers in the north of the netherlands a retrospective documentary analysis |
| topic | Asylum seekers Pregnancy outcomes Perinatal mortality Vulnerable women Substandard factors |
| url | http://link.springer.com/article/10.1186/s12884-020-02985-x |
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