Maternal and infant outcomes of Syrian and Palestinian refugees, Lebanese and migrant women giving birth in a tertiary public hospital in Lebanon: a secondary analysis of an obstetric database

Stephen J McCall, Tanya C El Khoury, Hala Ghattas, Shady Elbassuoni, Mhd Hussein Murtada, Zeina Jamaluddine, Christine Haddad, Aya Hussein, Amina Krounbi, Jocelyn DeJong, Janoub Khazaal, Rabih Chahine* (Corresponding Author)

*Corresponding author for this work

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Abstract

Objectives This study aims to assess whether the characteristics, management and outcomes of women varied between Syrian and Palestinian refugees, migrant women of other nationalities and Lebanese women giving birth at a public tertiary centre in Beirut, Lebanon.

Methods This was a secondary data analysis of routinely collected data from the public Rafik Hariri University Hospital (RHUH) between January 2011 and July 2018. Data were extracted from medical notes using text mining machine learning methods. Nationality was categorised into Lebanese, Syrian, Palestinian and migrant women of other nationalities. The main outcomes were diabetes, pre-eclampsia, placenta accreta spectrum, hysterectomy, uterine rupture, blood transfusion, preterm birth and intrauterine fetal death. Logistic regression models estimated the association between nationality and maternal and infant outcomes, and these were presented using ORs and 95% CIs.

Results 17 624 women gave birth at RHUH of whom 54.3% were Syrian, 39% Lebanese, 2.5% Palestinian and 4.2% migrant women of other nationalities. The majority of women had a caesarean section (73%) and 11% had a serious obstetric complication. Between 2011 and 2018, there was a decline in the use of primary caesarean section (caesarean section performed for the first time) from 7% to 4% of births (p
Conclusion Syrian refugees in Lebanon had similar obstetric outcomes compared to the host population, except for very preterm birth. However, Palestinian women and migrant women of other nationalities appeared to have worse pregnancy complications than the Lebanese women. There should be better healthcare access and support for migrant populations to avoid severe complications of pregnancy.
Original languageEnglish
Article numbere064859
Number of pages16
JournalBMJ Open
Volume13
Issue number2
Early online date22 Feb 2023
DOIs
Publication statusPublished - 22 Feb 2023

Bibliographical note

Acknowledgments
We would like to thank Rafik Hariri University Hospital for providing the data for this study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Data Availability Statement

Data are available upon reasonable request. Data are available upon request to RHUH.

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