Ahmet YAĞMUR BAŞ, Leyla MOLLAMAHMUTOĞLU, İstemi Han ÇELİK, Ömer LÜTFİ TAPISIZ, Dilek ULUBAŞ IŞIK, Zehra ARSLAN, Nihal DEMİREL

Neonatal outcomes in Syrian and other refugees treated in a tertiary hospital in Turkey

Background/aim: Turkey accepts refugees from many countries, principally Syria. More than 2.7 million refugees live in Turkey. Weevaluated the neonatal outcomes of refugees.Materials and methods: We retrospectively reviewed the clinical and demographic characteristics of refugee infants born in our hospitalbetween August 2013 and September 2016.Results: Refugees (718 Syrian, 136 Iraqi, 32 Afghani, and 21 of other nationalities) accounted for 907 of 49,413 births. The mean refugeematernal age was lower than that of Turkish women, whereas the gestational age (GA) and birthweight were similar. Refugees requiredfewer cesarean sections but exhibited greater small- and large-for-GA rates (P < 0.05). Refugee and Turkish infant mortality rates didnot differ significantly (0.8 vs. 0.4%). Eighty-nine (12.3%) refugee neonates and 6682 (13.5%) Turkish neonates were admitted to ourneonatal intensive care unit (NICU). Jaundice and perinatal asphyxia were significantly more common in refugees, whereas respiratorydistress syndrome, GA ≤32 weeks, and infant birthweight

PDF

___

1. United Nations High Commissioner for Refugees. UNHCR Global Appeal 2016-2017. Geneva, Switzerland: UNHCR; 2017.
2. United Nations High Commissioner for Refugees. Syria Regional Refugee Response. Geneva, Switzerland: UNHCR; 2018.
3. 3RP. Regional Refugee and Resilience Plan 2016-2017 in Response to Syria Crisis. Geneva, Switzerland: 3RP; 2015.
4. AFAD. Current Status in AFAD Temporary Protection Centres. Ankara, Turkey: AFAD; 2017.
5. European Commission. Humanitarian Aid and Civil Protection. Brussels, Belgium: European Commission; 2018.
6. AFAD. Republic of Turkey Prime Ministry Disaster and Emergency Management Presidency. Syrian Refugees in Turkey, 2013: Field Survey Results. Ankara, Turkey: AFAD; 2013.
7. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114 (1): 297-316. doi: 10.1542/peds.114.1.297
8. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics 2013; 13: 59. doi: 10.1186/1471-2431-13-59.
9. National Medical Rescue Team. Medical Services to Syrian Refugees. Ankara, Turkey: UMKE; 2016.
10. Buyuktiryaki M, Canpolat FE, Alyamac Dizdar E, Okur N, Kadioglu Simsek G. Neonatal outcomes of Syrian refugees delivered in a tertiary hospital in Ankara, Turkey. Conflict and Health 2015; 9: 38. doi: 10.1186/s13031-015-0066-1
11. Erenel H, Aydogan Mathyk B, Sal V, Ayhan I, Karatas S et al. Clinical characteristics and pregnancy outcomes of Syrian refugees: a case-control study in a tertiary care hospital in Istanbul, Turkey. Archives of Gynecology and Obstetrics 2017; 295 (1): 45-50. doi: 10.1007/s00404-016-4188-5
12. 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 Journal of Biology and Medicine 2014; 87 (3): 269-288.
13. Khawaja M, Choueiry N, Jurdi R. Hospital-based caesarean section in the Arab region: an overview. Eastern Mediterranean Health Journal 2009; 15 (2): 458-469.
14. Demirci H, Yildirim Topak N, Ocakoglu G, Karakulak Gomleksiz M, Ustunyurt E et al. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015. International Journal of Gynecology & Obstetrics 2017; 137 (1): 63-66. doi: 10.1002/ijgo.12088
15. Benage M, Greenough PG, Vinck P, Omeira N, Pham P. An assessment of antenatal care among Syrian refugees in Lebanon. Conflict and Health 2015; 9: 8. doi: 10.1186/s13031- 015-0035-8
16. Wannous S, Arous S. Incidence and determinants of low birth weight in Syrian government hospitals. Eastern Mediterranean Health Journal 2001; 7 (6): 966-974.
17. Reese Masterson A, Usta J, Gupta J, Ettinger AS. Assessment of reproductive health and violence against women among displaced Syrians in Lebanon. BMC Women’s Health 2014; 14 (1): 25. doi: 10.1186/1472-6874-14-25
18. Centers for Disease Control. QuickStats: Percentage of Smallfor-Gestational-Age Births, by Race and Hispanic Ethnicity--- United States, 2005. Atlanta, GA, USA: CDC; 2005.
19. Kavurt S, Ozcan B, Aydemir O, Bas AY, Demirel N. Risk of retinopathy of prematurity in small for gestational age premature infants. Indian Pediatrics 2014; 51 (10): 804-806. doi: 10.1007/s13312-014-0506-9
20. Ulubaş-Işık D, Erol S, Demirel N, Kale Y, Çelik İH et al. Earlyterm delivery and adverse neonatal outcomes at a tertiary center in Turkey. Turkish Journal of Pediatrics 2015; 57 (6): 547-552.
21. Bouchghoul H, Hornez E, Duval-Arnould X, Philippe HJ, Nizard J. Humanitarian obstetric care for refugees of the Syrian war. The first 6 months of experience of Gynecologie Sans Frontieres in Zaatari Refugee Camp (Jordan). Acta Obstetricia et Gynecologica Scandinavica 2015; 94 (7): 755-759. doi: 10.1111/aogs.12638
22. Ministry of Health of Turkey. Yearly Health Statistics. Ankara, Turkey: Ministry of Health; 2013 (in Turkish).
23. United Nations Children Fund (UNICEF). Country Profile Syria, Maternal, Newborn and Child Survival. New York, NY, USA: UNICEF; 2012.