Abstract
Introduction The aim of this study was to record the perinatal data of refugee women at Charité
Hospital, Berlin, and to evaluate possible differences in pre-, peri- and postnatal
outcomes compared with indigenous women.
Material and Methods All pregnant women who gave birth in the period from 1 January 2014 to 30 September
2017 and were registered at least once in the hospital as “refugee” were included
in the analysis. The data recorded from the refugee women were compared with the perinatal
data of the German Federal obstetric analysis for the year 2016, which was published
by the IQTIG (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen
[Institute for Quality Assurance and Transparency in Healthcare]).
Results The analysis comprised 907 refugee women and 928 infants (21 twin pregnancies). Pregnant
refugee women were significantly younger than the pregnant women from the Federal
analysis (birth before the age of 30: 66 vs. 41%, p < 0.001, RR: 1.6, 95% CI: 62.9 – 69.2).
They had a history both of more pregnancies (≥ 3 pregnancies: 29.4 vs. 13.4%, p < 0.001,
RR: 2.2, 95% CI: 26.4 – 32.5) and of more miscarriages (> 2 miscarriages: 9.7 vs.
5.9%, p < 0.001, RR: 1.6, 95% CI: 7.9 – 11.8) and more often had a history of suffering
from psychological stress (11.1 vs. 4.1%, p < 0.001, RR: 2.70, 95% CI: 9.2 – 13.4).
There were more premature births (10.3 vs. 3.0%, p < 0.001, RR: 3.36, 95% CI: 8.4 – 12.4),
post-term pregnancies (8.5 vs. 0.5%, p < 0.001, RR: 15.4, 95% CI: 6.7 – 10.5), and
cases of postpartum anaemia (28.7 vs. 22.0%, p < 0.001, RR: 1.30, 95% CI: 25.7 – 31.7)
and puerperal endometritis (1 vs. 0.2%, p = 0.006, RR: 4.3, 95% CI: 0.5 – 1.9)
compared with the Federal analysis. The neonatal outcome showed an increased
rate of hypotrophy (11 vs. 7%, p < 0.001, RR: 1.6, 95% CI: 9.1 – 13.2), more stillbirths
(0.7 vs. 0.2%, p = 0.006, RR: 3, 95% CI: 0.2 – 1.4) and increased congenital malformations
(2.8 vs. 0.4%, p < 0.001, RR: 3, 95% CI: 0.2 – 1.4).
Conclusion Both refugee women and their infants showed significant differences. Despite the
average younger age of the pregnant refugee women, the rates of premature birth and
stillbirth and congenital malformations were significantly more frequent. More intensive
antenatal screening with differentiated foetal organ diagnostics including psychosomatic
care could contribute to early identification and prompt diagnosis. As regards the
postpartum anaemia and puerperal endometritis, which occur more often in refugee women,
midwife engagement and an improvement in the living situation in homes and accommodation
facilities could be of great importance.
Key words
pregnancy - complications - refugees - Germany - infants
