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 χ 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.
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