Analysis Of Perinatal Outcomes Of Syrian Refugees In The Province Of Kirsehir

Yıl 2019, Cilt: 3 Sayı: 1, 6 - 11, 28.04.2019

Füsun Karbancıoğlu Cantürk Selda Songur Dağlı Mehmet Cantürk

Öz

Purpose: To determine antenatal and perinatal outcomes of Syrian refugees delivered in our hospital at 2017 and to compare their results with Turkish
parturients. Also to make a contribution to studies made for refugees’ access to health services by determining their obstetric problems.

Materıals and Method: Medical files of patients delivered at our hospital in 2017 were retrospectively assessed. 152 Syrian refugees and 196 Turkish
parturient were included in the study. Age, parity, maternal hemoglobin at delivery , HbsAg, number of admissions to antenatal policlinics, cesarean
indications, delivery mode, neonatal birth weight, Apgar scores were recorded.

Results: There was no hospital records of 71(46,7%) of 152 refugees until birth. All Turkish parturients admitted to hospital at least twice at antenatal
period. The mean age of refugees was significantly lower , the mean parity number and adolescent pregnancy rate was significantly higher in refugees.
The mean gestational week at delivery and neonatal birth weight were significantly lower. Preterm labor and low birth weight rate were significantly
higher in study group. The 1st
minute Apgar scores were significantly lower in study group. Maternal anemia rate was significantly higher in refugees.
The cesarean delivery rate and primary cesarean rate were significantly higher in control group.

Conclusion: There is a statistically significant difference between Syrian refugees and Turkish citizens in terms of number of admissions to hospital
at antenatal period and perinatal outco

Anahtar Kelimeler

Syrian Refugees, Antenatal Visits, Perinatal Outcomes

Kırşehir İlindeki Suriyeli Mültecilerin Perinatal Sonuçlarının Değerlendirilmesi

Öz

Amaç: Hastanemizde 2017 yılında doğum yapan Suriyeli mültecilerin antenatal ve perinatal durumlarını inceleyerek Türk gebelerle karşılaştırmak ve
bu gebelerin riskli durumlarını saptayarak sağlık kurumlarına erişimleri ve hizmet kullanımları için yapılan çalışmalara katkı sağlamaktır.

Araçlar ve Yöntem: 2017 yılında hastanemizde doğum yapan mülteci gebelerin dosyaları retrospektif olarak incelenmiştir, 152 mülteci gebe çalışma
grubunda yer almıştır. Aynı yıl içinde doğum yapan 196 Türk gebe kontrol grubunda yer almıştır. Bu gebelerin yaşı, gebelik sayısı, doğum sırasındaki
hemoglobin düzeyi, HbsAg taşıyıcılığı, antenatal takip sayısı, doğum şekli, sezaryen endikasyonu, doğum sırasındaki gebelik haftası, bebek doğum
ağırlığı, bebeğin Apgar skorları değerlendirmeye alınmıştır.

Bulgular: 152 mülteci gebenin 71 tanesinin (%46.7) doğuma kadar hiç hastane kaydı yoktu. Kontrol grubundaki 196 Türk gebe arasında takipsiz gebe
yoktu. Mülteci grubuyla kontrol grubu karşılaştırıldığında; mülteci grubun yaş ortalaması anlamlı olarak daha düşük, ortalama parite sayısı anlamlı
olarak daha yüksekti. Adölesan gebelik oranı mültecilerde anlamlı olarak daha yüksekti. Mülteci grupta doğumda gebelik haftası ve ortalama bebek
doğum ağırlığı anlamlı olarak daha düşüktü, preterm doğum oranı ve düşük doğum ağırlıklı bebek oranı anlamlı olarak daha yüksekti. Mülteci grupta
1. dakika Apgar skoru ve 5. dakika Apgar skoru <7 olan bebek sayısı anlamlı olarak daha yüksekti. Mülteci grupta anemi oranı anlamlı olarak daha
yüksekti. Kontrol grubunda sezaryenle doğum oranı ve primer sezaryen oranı anlamlı olarak daha yüksekti.

Sonuç: Mülteci gebelerle Türk gebelerin antenatal takip sayılarında ve perinatal sonuçlarında anlamlı farklılıklar vardır. Mülteci gebelerin daha düzenli
takiplerinin ve tedavilerinin yapılması hem anne hem de bebek sağlığı için önemlidir. 

Anahtar Kelimeler

Suriyeli Mülteci, Antenatal Takip, Perinatal Sonuç

Kaynakça

• 1. AFAD (2016) Republic of Turkey Prime Ministry. Disaster and Emergency Management Presidency. Syrian Refugees in Turkey, 2013: Field Survey Results. 2016. [Internet] https://www.afad.gov. tr/Dokuman/TR/61-2013123015505-syrian-refugees-in-turkey-2013_print_12.11.2013_eng.pdf.
• 2. Karakaya E, Coşkun AM, Yakıt E. Suriyeli mülteci kadınların doğurganlık özellikleri ve etkileyen faktörler: Kalitatif bir çalışma. Uluslararası Sosyal Araştırmalar Dergisi, 2017; 10(48): 417 – 428.
• 3. Jessen A (2013). “The Government of Turkey and Syrian Refugees”, http://issuu.com/georgetownsfs/docs/jessen_2013_-final (ET:10.09.2018) .
• 4. Şimşek Z, Doğan F, Hilali NG, Özek B. Bir il merkezinde yaşayan 15-49 yaş evli Suriyeli kadınlarda üreme sağlığı göstergeleri ve hizmet ihtiyacı. 18. Ulusal Halk Sağlığı Kongresi Bildiri Kitabı. Konya.
• 5. Johnson EB, Reed SD, Hitti J, Batra M. Increased risk of adverse pregnancy outcome among Somali immigrants in Washington state. Am J Obstet Gynecol, 2005; 193:475–482.
• 6. Gibson-Helm M, Teede H, Block A, Knight M, East C, Wallace EM, Boyle J. Maternal health and pregnancy outcomes among women of refugee background from African countries: a retrospective, observational study in Australia. BMC Pregnancy Childbirth, 2014; 14: 392.
• 7. Gibson-Helm M, Boyle J, Cheng IH, East C, Knight M, Teede H. Maternal health and pregnancy outcomes among women of refugee background from Asian countries. Int J Gynaecol Obstet, 2015; 129: 146–151.
• 8. Gagnon AJ, McDermott S, Rigol-Chachamovich J, Bandyopadhyay M, Stray-Pedersen B, Stewart D, Collaboration ROAM International migration and gestational diabetes mellitus: a systematic review of the literature and meta-analysis. Paediatr Perinat Epidemiol, 2011; 25: 575–592.
• 9. Merry L, Small R, Blondel B, Gagnon AJ. International migration and caesarean birth: a systematic review and meta-analysis. BMC Pregnancy Childbirth, 2013; 13: 27.
• 10. Wanigaratne S, Cole DC, Bassil K, Hyman I, Moineddin R, Urquia ML. The influence of refugee status and secondary migration on preterm birth. J Epidemiol Community Health, 2016; 70: 622–628.
• 11. Mutlu Y, Kırımsoy E, Antakyalıoğlu Ş. Suriyeli Mülteci Çocuklar ve Vatansızlık Riski, Bulanık Mekânlarda Gölgede Kalanlar, Araştırma Raporu, Gündem Çocuk Derneği, 2016 Şen Matbaa, Ankara.
• 12. Erenel H, Mathyk B, Sal V, Ayhan I, Karataş S, Bebek A. Clinical characteristics and pregnancy outcomes of Syrian refugees: a case–control study in a tertiary care hospital in Istanbul, Turkey. Arch Gynecol Obstet. 2017; 295: 45–50. 13. Benage M, Greenough PG, Vinck P, Omeira N, Pham P. An assessment of antenatal care among Syrian refugees in Lebanon. Confl Health, 2015;9:1.
• 14. Demirci H, Topak N, Ocakoğlu G, Gömleksiz M, Üstünyurt E, Türker A. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015. Int J Gynecol Obstet. 2017;137:63–6.
• 15. Mckeary M, Newbold KB. Barriers to care: the challenges for Canadian refugees and their health care providers. J Refug Stud, 2010; 23: 523–545.
• 16. Shah RR, Ray JG, Taback N, Meffe F, Glazier RH. Adverse pregnancy outcomes among foreign-born Canadians. J Obstet Gynaecol Can, 2011; 33: 207–215.
• 17. Makhoul G, Falakha G, Makhoul CN, AbdelAhad A. International perspectives: impact of Syrian refugees on Neonatal Care in Hopital Notre Dame de la Paix, Akkar, North Lebanon. NeoReviews, 2015; 16(8): e456–e461.
• 18. Reese Masterson A, Usta J, Gupta J, Ettinger AS. Assessment of reproductive health and violence against women among displaced Syrians in Lebanon. BMC Womens Health, 2014;14:25.
• 19. Huster KM, Patterson N, Schilperoord M, Spiegel P. Cesarean sections among Syrian refugees in Lebanon from december 2012/january 2013 to june 2013: probable causes and recommendations. Yale J Biol Med, 2014; 87: 269–88.
• 20. Gümüş G, Kaya A, Yılmaz SŞ, Özdemir S, Başıbüyük M, Coşkun AM. Suriyeli mülteci kadınların üreme sağlığı sorunları. KASHED,2017 3(1):1-17.
• 21. Baş D, Arkant C, Muqat A, Arafa M, Sipahi T, Eskiocak M. Edirnedeki Suriyeli sığınmacıların durumu. 18. Ulusal Halk Sağlığı Kongresi Kitabı, 2015; 214-215.
• 22. United Nations International Children’s Emergency Fund(home page on the ınternet). Fertility and Family Planning (updated July 5, 2005). Available at : www.unicef.org/specialsession/about/sgreport-pdf/10-fertility family planning D7341 Insert English.pdf.Accessed July 12, 2005.
• 23. Jolly MC, Sebire N, Harris J, Robinson S, Regan L. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol. 2000; 96: 962-966.
• 24. Rosengard , Phipps MG, Adler NE, Ellen JM. Adolescent pregnancy intentions and pregnancy outcomes: a longitudinal examination. J Adolesc Health. 2004;35:453-461.
• 25. Alnuaimi K, Kassab M, Ali R, Mohammad K, Shattnawi K. Pregnancy outcomes among Syrian refugee and Jordanian women: a comparative study. Int Nurs Rev, 2017;64:584–92.
• 26. Ekmekçi PE(2016) Syrian refugees, health and migration legislation in Turkey. J Immigr Minor Health. 2017 Dec;19(6):1434-1441.
• 27. Sak ME, Özkul Ö, Evsen MS, Sak S, Evliyaoğlu O: Gebelik Anemisinin Perinatal Sonuçlara Etkisi. Dicle Tıp Dergisi, 2009; 36(1): 39-42.
• 28. Rasmussen KM: Is There a Causal Relationship between Iron Deficiency or Iron-Deficiency Anemia and Weight at Birth, Length of Gestation and Perinatal Mortality? The Journal of Nutrition, 2001; 131(2): 590 – 603.
• 29. Lone FW, Qureshi BN ,Emanuel F: Maternal anaemia and its impact on perinatal outcome: Tropical Medicine and International Health, 2004; 9(4): 486 – 490.
• 30. UJ Bakhtiar, Y Khan, R Nasar : Relationship between maternal hemoglobin and perinatal outcome. RMJ 2007; 32(2): 102-104.
• 31. Fleming AF: A Study of Anemia of Pregnancy in Ibadan, Western Nigeria with Special Reference to Folic Acid Deficieny. MD Thesis, University of Cambridge. 1991 Quoted by A. Hughes in ‘ Anemia of Pregnancy’ Maternal Health and Safe Motherhood, WHO,1991.
• 32. Büyüktiryaki M, Canpolat FE, Alyamac¸ Dizdar E, Okur N, Kadıoğlu S, et al. Neonatal outcomes of Syrian refugees delivered in a tertiary hospital in Ankara, Turkey. Confl Health, 2015;9:38.
• 33. Sorbye IK, Daltveit AK, Sundby J, Stoltenberg C, Vangen S. Cesarean section by immigrants’ length of residence in Norway: a population based study. Eur J Pub Health, 2015; 25: 78-84.
• 34. Kandasamy T, Cherniak R, Shah R, Yudin M, Spitzer R. Obstetric Risks and Outcomes of Refugee Women at a Single Centre in Toronto. J Obstet Gynaecol Can, 2014; 36: 296–302.
• 35. Drukker L.Iron deficiency anemia at admission for labor and delivery is associated with an increased risk for cesarean section and adverse maternal and neonatal outcomes. Transfusion, 2015; 55(12): 2799–2806.
• 36. Samari, G. (2014) “The Response to Syrian Refugee Women’s Health Needs in Lebanon, Turkey and Jordan and Recommendations for Improved Practice” as part of the 2014 Humanity in Action. Diplomacy and Diversity Fellowship. Available at: www.humanityinaction.org/. . ./583-the-response-to-syrian-refugee-wome (accessed 18 February 2017).
• 37. Güngör ES, Seval O, İlhan G, Verit FF. Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul. Turk J Obstet Gynecol, 2018; 15: 23-7.