Obstetric practice differences between Syrian refugees and non-Syrian nonrefugee gravidae: A retrospective cross-sectional study

Abstract

Objective: To assess differences in obstetric practices between Syrian war refugees (SRs) and non-Syrian nonrefugees (NSRs) in a tertiary care provider in Germany. Methods: This was a retrospective study of SRs (n= 356) and NSRs (n= 5836) giving birth between January 2015 and December 2018. Data on medical history, birth mode, complications, and neonatal parameters was extracted. Group differences were evaluated using Mann–Whitney and χ2 test. Logistic regression models were fitted to investigate the association of refugee status with mode of birth in conditions associated with increased risk of cesarean section (CS). Results: SRs had higher rates of adolescent pregnancies (1.7% versus 0.6%, P= 0.020) but fewer maternal diseases compared with NSRs (1.7% versus 3.9%, P= 0.035). The rate of CS was higher in the NSR group (43.9% versus 36%, P= 0.003), as well as the rates of premature rupture of membranes (P= 0.006) and steroid administration for lung maturation (P= 0.012). Cases of umbilical artery pH ≤7.0 were more common in SRs (0.4% versus 1.1%, P= 0.027). Women with previous CS had similar odds of CS in the current pregnancy irrespective of study group (odds ratio, 0.94 [95% confidence interval, 0.50–1.75]). Conclusion: SR women had lower rates of CS but higher rates of adolescent pregnancies and neonatal pH ≤7.0 at birth compared with NSR women.