Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Noor C Gieles; Julia B Tankink; Myrthe van Midde; Johannes Düker; Peggy van der Lans; Catherina M Wessels; Kitty W M Bloemenkamp; Gouke Bonsel; Thomas van den Akker; Simone Goosen; Marcus J Rijken; Joyce L Browne

doi:10.1093/eurpub/ckz042

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

Noor C Gieles, Julia B Tankink, Myrthe van Midde, Johannes Düker, Peggy van der Lans, Catherina M Wessels, Kitty W M Bloemenkamp, Gouke Bonsel, Thomas van den Akker, Simone Goosen, Marcus J Rijken, Joyce L Browne

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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.

Original language	English
Pages (from-to)	714-723
Number of pages	10
Journal	European Journal of Public Health
Volume	29
Issue number	4
Early online date	16 May 2019
DOIs	https://doi.org/10.1093/eurpub/ckz042
Publication status	Published - 1 Aug 2019

Keywords

psychiatric hospital
low birth weight infant
mothers
morbidity
premature birth
perinatal period
lgal status

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Gieles, N. C., Tankink, J. B., van Midde, M., Düker, J., van der Lans, P., Wessels, C. M., Bloemenkamp, K. W. M., Bonsel, G., van den Akker, T., Goosen, S., Rijken, M. J., & Browne, J. L. (2019). Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review. European Journal of Public Health, 29(4), 714-723. https://doi.org/10.1093/eurpub/ckz042

@article{096f5b94f91f4e0ea2fc0908ed5b7eb8,

title = "Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review",

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.",

keywords = "psychiatric hospital, low birth weight infant, mothers, morbidity, premature birth, perinatal period, lgal status",

author = "Gieles, {Noor C} and Tankink, {Julia B} and {van Midde}, Myrthe and Johannes D{\"u}ker and {van der Lans}, Peggy and Wessels, {Catherina M} and Bloemenkamp, {Kitty W M} and Gouke Bonsel and {van den Akker}, Thomas and Simone Goosen and Rijken, {Marcus J} and Browne, {Joyce L}",

note = "Funding Information: We received the generous support of the Van Walree grant by the Royal Netherlands Academy of Arts and Sciences (KNAW) to present at the 1st World Congress on Migration, Ethnicity, Race and Health (Edinburgh, 17–19 May 2018). Publisher Copyright: {\textcopyright} 2019 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

year = "2019",

month = aug,

day = "1",

doi = "10.1093/eurpub/ckz042",

language = "English",

volume = "29",

pages = "714--723",

journal = "European Journal of Public Health",

issn = "1101-1262",

publisher = "Oxford University Press",

number = "4",

}

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 2019, 'Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review', European Journal of Public Health, vol. 29, no. 4, pp. 714-723. https://doi.org/10.1093/eurpub/ckz042

TY - JOUR

T1 - Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe

T2 - a systematic review

AU - Gieles, Noor C

AU - Tankink, Julia B

AU - van Midde, Myrthe

AU - Düker, Johannes

AU - van der Lans, Peggy

AU - Wessels, Catherina M

AU - Bloemenkamp, Kitty W M

AU - Bonsel, Gouke

AU - van den Akker, Thomas

AU - Goosen, Simone

AU - Rijken, Marcus J

AU - Browne, Joyce L

N1 - Funding Information: We received the generous support of the Van Walree grant by the Royal Netherlands Academy of Arts and Sciences (KNAW) to present at the 1st World Congress on Migration, Ethnicity, Race and Health (Edinburgh, 17–19 May 2018). Publisher Copyright: © 2019 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - 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.

AB - 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.

KW - psychiatric hospital

KW - low birth weight infant

KW - mothers

KW - morbidity

KW - premature birth

KW - perinatal period

KW - lgal status

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U2 - 10.1093/eurpub/ckz042

DO - 10.1093/eurpub/ckz042

M3 - Review article

C2 - 31098629

SN - 1101-1262

VL - 29

SP - 714

EP - 723

JO - European Journal of Public Health

JF - European Journal of Public Health

IS - 4

ER -

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

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