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Gieles NC, Tankink JB, van Midde M, Düker J, van der Lans P, Wessels CM, Bloemenkamp KWM, Bonsel G, van den Akker T, Goosen S, Rijken MJ, Browne JL. Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review. Eur J Public Health 2020; 29:714-723. [PMID: 31098629 PMCID: PMC6734941 DOI: 10.1093/eurpub/ckz042] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Asylum seekers (AS) and undocumented migrants (UM) are at risk of adverse pregnancy outcomes due to adverse health determinants and compromised maternal healthcare access and service quality. Considering recent migratory patterns and the absence of a robust overview, a systematic review was conducted on maternal and perinatal outcomes in AS and UM in Europe. Methods Systematic literature searches were performed in MEDLINE and EMBASE (until 1 May 2017), complemented by a grey literature search (until 1 June 2017). Primary research articles reporting on any maternal or perinatal outcome, published between 2007 and 2017 in English/Dutch were eligible for inclusion. Review protocols were registered on Prospero: CRD42017062375 and CRD42017062477. Due to heterogeneity in study populations and outcomes, results were synthesized narratively. Results Of 4652 peer-reviewed articles and 145 grey literature sources screened, 11 were included from 4 European countries. Several studies reported adverse outcomes including higher maternal mortality (AS), severe acute maternal morbidity (AS), preterm birth (UM) and low birthweight (UM). Risk of bias was generally acceptable, although the limited number and quality of some studies preclude definite conclusions. Conclusion Limited evidence is available on pregnancy outcomes in AS and UM in Europe. The adverse outcomes reported imply that removing barriers to high-quality maternal care should be a priority. More research focussing on migrant subpopulations, considering potential risk factors such as ethnicity and legal status, is needed to guide policy and optimize care.
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Affiliation(s)
- Noor C Gieles
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Julia B Tankink
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Myrthe van Midde
- Research Department, Médecins du Monde/Dokters van de Wereld, Amsterdam, The Netherlands
| | - Johannes Düker
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peggy van der Lans
- Department of Gynaecology and Obstetrics, Hospital Twente ZGT/MST, Enschede, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands
| | - Catherina M Wessels
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kitty W M Bloemenkamp
- Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gouke Bonsel
- Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas van den Akker
- Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands.,Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Simone Goosen
- Netherlands Association of Community Health Services, Utrecht, The Netherlands
| | - Marcus J Rijken
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands.,Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joyce L Browne
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Dutch Working Party on International Safe Motherhood and Reproductive Health, Amsterdam, The Netherlands
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