6670 Seeking refuge in the NICU: comparative analysis of antenatal and perinatal outcomes among refugee and resident women in a tertiary hospital

Objectives The influx of refugees poses diverse challenges to healthcare systems, particularly concerning maternal and neonatal health. This study aimed to compare antenatal and perinatal outcomes between refugee and native women in a tertiary care centre. Methods The data of 323 babies and their mothers, all of whom delivered at our tertiary care hospital, were retrospectively collected between July 2022 and January 2023. We compared antenatal parameters, including maternal age, gravida status, abortus status, history of in vitro fertilization (IVF), multiple gestations, and antenatal steroid use. We also evaluated the mode of delivery, premature rupture of membranes (PROM), and adherence to prenatal follow-up. Newborn outcomes were also assessed, encompassing resuscitation requirements at birth, gestational age, birth weight, categorization as small for gestational age (SGA), presence of congenital anomalies, reasons for NICU admission, mechanical ventilation requirements, feeding difficulties, specific morbidities encountered in the NICU, length of hospital stay, and mortality rate. Results This retrospective cohort study analysed data from 74 refugee newborn (45 from Syria, 21 from Iraq, 5 from Afghanistan, and 3 from Somalia) and 249 native newborn. Refugee women, compared to their native counterparts, had a significantly lower median maternal age [27.0 (15.0–45.0) vs. 29.0 (17.0–44.0), p=0.006] and a higher gravida status [3.0 (1.0–11.0) vs. 2.0 (1.0–10.0), p<0.05]. In contrast, native women exhibited higher instances of IVF and multiple gestations (19.3% vs. 8.1%, p=0.015), as well as greater antenatal steroid use (32.9% vs. 13.5%, p=0.005). However, there was no significant difference in birth weight between the two groups (2441.71 ± 786.96 vs. 2495.20 ± 843.32, p=0.614). Notably, RDS and feeding problems were more prevalent among refugee newborns (p<0.05), whereas TTN was more common in native neonates (p=0.016). Antenatal follow-up adherence was significantly lower among refugee parents (p=0.001). There were no significant disparities regarding gestational age, abortus status, nature of pregnancy, delivery mode, PROM, reasons for NICU admission, ventilation requirements, morbidities in NICU, and neonatal mortality rate (p>0.05). Conclusion Refugees have been residing in our country since 2011 and have access to free healthcare services. However, cultural, and traditional differences lead to inadequate adherence to antenatal and postnatal care. Particularly concerning are the feeding issues and RDS in refugee infants and the low follow-up adherence, pointing to barriers in healthcare access or utilization. These insights are crucial for practitioners working to optimize perinatal care and maternal-child health initiatives for vulnerable populations.