Scripties UMCG - Rijksuniversiteit Groningen
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Pregnancy outcomes in Asylum Seekers in the Netherlands

(2018) Verschuuren, A.E.H. (Anouk)

Background: The number of refugees seeking asylum in the Netherlands has been growing since 2016. Pregnant asylum seekers seem to be at risk of poor pregnancy outcome, however, in the Netherlands, pregnancy outcomes of this vulnerable population have not yet been assessed. This study aims to study the current difference in maternal and perinatal outcomes between asylum seekers and the local Dutch population.
Methods: Using a retrospective cross-sectional study design we compared pregnancy outcomes of asylum seeking women (n=345) and Dutch women (n=2324) who delivered in a region in the North of the Netherlands between January 2012 and December 2016.Primary and secondary care data derived from Perined Insight were included, among which perinatal mortality, premature delivery, small for gestational age (SGA), Apgar score, delivery by caesarean section and assisted delivery.
Results: Perinatal mortality (3.5% vs. 0.6%, P=0.000) and SGA children (13.9% vs. 8.4%, P=0.002) were significantly more common in asylum seekers. Apgar scores (9.23 vs. 9.61, P=0.042) were significantly lower and postnatal hospital stay of the mother is significantly longer (2.25 vs. 1.72 days, P=0.005) as compared to Dutch women. Prematurity and mode of delivery showed no significant difference. Multivariate analysis showed that being an asylum seeker is a risk factor for perinatal mortality independent from parity, birth weight and pregnancy duration.
Conclusion: Pregnant asylum seekers are a high-risk population with increased rates of adverse pregnancy outcomes. Additionally, being an asylum seeker is an independent risk factor for poor perinatal outcome independent from parity, birth weight and pregnancy duration. More research is needed to identify specific risk factors for poor perinatal outcomes in asylum seekers and to identify strategies to improve perinatal care.

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