Geçirilmiş multipl sezaryen öyküsü bakımından Suriyeli mülteci ve yerleşik Türk vatandaşı gebelerin karşılaştırılması

Yıl 2020, Cilt: 11 Sayı: 4, 243 - 249, 30.09.2020

Hakan Çökmez , Çetin Aydın

https://doi.org/10.18663/tjcl.669555

Öz

Amaç: Suriyeli mülteci ve yerleşik Türk vatandaşı gebelerin, gebelik sonuçlarını geçirilmiş sezaryen sayısı bakımından karşılaştırmak.
Gereç ve Yöntemler: Bu retrospektif kohort çalışmaya 1 Ocak 2017 ile 1 Ağustos 2018 tarihleri arasında, üçüncü basamak bir hastanede sezaryen doğumu gerçekleşmiş, multiple sezaryen öyküsüne sahip Suriyeli mülteci ve yerleşik Türk vatandaşı gebeler dahil edildi. İki grup demografik veriler, geçirilmiş sezaryen sayıları, acil/elektif sezaryen sayıları, hematokrit düzeyleri ve yenidoğan ağırlıkları bakımından karşılaştırılarak analiz edildi.
Bulgular: Suriyeli mülteci gebeler arasında >2 multiple sezaryen öyküsüne sahip kadın oranı yerleşik Türk vatandaşları gebelerden fazlaydı (sırasıyla, %23,2; %11,1; p<0,05). Acil sezaryen doğum oranı Suriyeli mülteci gebelerde yerleşik Türk vatandaşı gebelere göre daha fazlaydı (sırasıyla %69,6; %55,4; p<0,05). Suriyeli mülteci grubu daha uzun gebelik süresine (39,08 ± 1,01 vs. 38,46 ± 1,50 hafta, p <0,001) ve daha düşük yenidoğan doğum ağırlığına (3117,83 ± 363,36 g vs. 3230,93 ± 472,67 g; p <0,05) sahipti.
Sonuç: Bulgularımız >2 sezaryen öyküsü ile Suriyeli mülteci gebeler arasında anlamlı bir ilişki olduğunu göstermiştir. Suriyeli mültecilerde gebelik süresi daha uzundu, yenidoğan doğum ağırlıkları daha düşüktü ve daha yüksek acil sezaryen oranları mevcuttu. Bu nedenle, Suriyeli mülteci gebelerde sezaryen ile ilişkili komplikasyonların zaman içerisinde giderek artabileceğini düşünüyoruz.

Anahtar Kelimeler

mülteciler, gebelik sonuçları, prenatal bakım, sezaryen

Destekleyen Kurum

Yok

Comparison between pregnant Syrian refugees and Turkish residents in terms of a history of multiple cesarean sections

Öz

Aim: To compare pregnancy outcomes between pregnant Syrian refugees and Turkish citizens with a history of multiple cesarean sections.
Material and Methods: The pregnant women included in this retrospective cohort study were Syrian refugees and resident Turkish citizens with a history of multiple cesarean sections who were admitted between January 1 2017 and August 1 2018 in a tertiary hospital. All data about the demographics, multiple cesarean numbers, emergent/elective cesarean numbers, hematocrit values, and neonatal birth weights were comparatively analyzed between the two groups.
Results: The Syrian refugee group had a higher ratio of women with a history of >2 cesarean sections than the Turkish citizen group (23.2% vs 11.1%, p<0.05). The ratio of urgent cesarean section operations were higher in the Syrian refugee group than in the Turkish citizen group (69.6% vs 55.4%, p<0.05). The Syrian refugee group had longer pregnancy duration (39.08±1.01 vs 38.46±1.50 weeks, p<0.001) and lower neonatal birth weights (3117.83±363.36 g vs 3230.93±472.67 g, p<0.05).
Conclusion: Our data suggested a significant relationship between a history of >2 cesarean sections and the pregnant Syrian refugees. The Syrian refugees had longer pregnancy duration, lower neonatal birth weights, and a higher rate of emergency cesarean sections. Therefore, we think that complications related to caesarean section may increase gradually over time in Syrian refugee pregnant women.

Anahtar Kelimeler

refugees, pregnancy outcome, prenatal care, cesarean section

Kaynakça

• 1. United Nations Refugee Agency, Inter-agency Information Sharing Portal https://data2.unhcr.org/en/situations/syria (access: 2018.11.13).
• 2. Wanigaratne S, Cole DC, Bassil K, et al. The influence of refugee status and secondary migration on preterm birth. J Epidemiol Community Health. 2016;70(6):622-628. http://dx.doi.org/10.1136/jech-2015-206529
• 3. Wanigaratne S, Shakya Y, Gagnon AJ, et al. Refugee maternal and perinatal health in Ontario, Canada: a retrospective population based study. BMJ Open. 2018;8(4):e018979. http://dx.doi.org/10.1136/bmjopen-2017-018979
• 4. Demirci H, Toprak NY, Ocakoglu G, et al. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015. Int J Gynecol Obstet 2017;137(1):63-66. https://doi.org/10.1002/ijgo.120888
• 5. Erenel H, Aydogan Mathyk B, Sal V, et al. Clinical characteristics and pregnancy outcomes of Syrian refugees: a case–control study in a tertiary care hospital in Istanbul, Turkey. Arch Gynecol Obstet. 2016;295(1):45-50. https://doi.org/10.1007/s00404-016-4188-5
• 6. Uysal D, Cokmez H, Aydin C, et al. Emergency peripartum hysterectomy: A retrospective study in a tertiary care hospital in Turkey from 2007 to 2015. J Pak Med Assoc. 2018;68(3):487-489. PMID:29540895
• 7. Badfar G, Shohani M, Soleymani A, et al. Maternal anemia during pregnancy and small for gestational age: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2018;32(10):1728-1734. https://doi.org/10.1080/14767058.2017.1411477
• 8. Terkawi AS, Larkin SK, Tsang S, et al. Effects of hydroxyethyl starch 6% (130/0.4) on blood loss during cesarean delivery: a propensity-matched analysis. J Anesth 2016;30(5):796-802. https://doi.org/10.1007/s00540-016-2208-z
• 9. Khawaja M, Choueiry N, Jurdi R. Hospital-based caesarean section in the Arab region: An overview. East Mediterr Health J. 2009;15(2):458-469. PMID: 19554995
• 10. Huster KM, Patterson N, Schilperoord M, et al. 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(3):269-288. PMID: 25191143
• 11. Ekmekci PE. Syrian refugees, health and migration legislation in Turkey. J Immigr Minor Health. 2017;19(6):1434-1441. https://doi.org/10.1007/s10903-016-0405-3
• 12. Rogal SS, Poschman K, Belanger K, et al. Effects of posttraumatic stress disorder on pregnancy outcomes. J Affect Disord. 2007;102(1-3):137-143. https://doi.org/10.1016/j.jad.2007.01.003
• 13. Ahmed A, Bowen A, Feng CX. Maternal depression in Syrian refugee women recently moved to Canada: a preliminary study. BMC Pregnancy Childbirth. 2017;17(1):240. https://doi.org/10.1186/s12884-017-1433-2
• 14. Korukcu O, Aydın R, Conway J, et al. Motherhood in the shade of migration: A qualitative study of the experience of Syrian refugee mothers living in Turkey. Nurs Health Sci. 2018;20(1):46-53. https://doi.org/10.1111/nhs.12379
• 15. Karakaya E, Coskun Margirit A, Ozerdogan N, et al. Syrian refugee women's fertility characteristics and influencing factors: A qualitative study. J Int Soc Res. 2017;10(48):417-428. http://www.sosyalarastirmalar.com/cilt10/sayi48_pdf/4sosyoloji_psikoloji_felsefe/karakaya_eylem.pdf
• 16. Abbasi-Kangevari M, Amin K, Kolahi AA. Antenatal care utilization among Syrian refugees in Tehran: A respondent driven sampling method. Women Birth. 2019. https://doi.org/10.1016/j.wombi.2019.02.001
• 17. Ozel S, Yaman S, Kansu-Celik H, et al. Obstetric outcomes among Syrian refugees: a comparative study at a tertiary care maternity hospital in Turkey. Rev Bras Ginecol Obstet. 2018;40(11):673-679. https://doi.org/ 10.1055/s-0038-1673427
• 18. Turkay U, Aydin U, Caliskan E, et al. Comparison of the pregnancy results between adolescent Syrian refugees and local adolescent Turkish citizens who gave birth in our clinic. J Matern Fetal Neonatal Med. 2018:1-6. https://doi.org/10.1080/14767058.2018.1519016
• 19. Güngör ES, Seval O, İlhan G, et al. Do Syrian refugees have increased risk for worse pregnancy outcomes? Results of a tertiary center in Istanbul. Turk J Obstet Gynecol. 2018;15(1):23. PMID: 29662712
• 20. Alnuaimi K, Kassab M, Ali R, et al. Pregnancy outcomes among Syrian refugee and Jordanian women: a comparative study. Int Nurs Rev. 2017;64(4):584-592. https://doi.org/10.1111/inr.12382
• 21. Abdin L. Challenges for pregnant Syrian refugees in Lebanon. East Mediterr Health. 2018;24(10):1026-1029. https://doi. org/10.26719/2018.24.10.1026
• 22. Gultac AS, Balcik PY. Health policy for Syrian Asylum Seekers. Sakarya Med J. 2018;8(2):193-204. https://doi.org/10.31832/smj.394732