Zwangerschapsuitkomsten en zorgbehoeften bij asielzoeksters

OBJECTIVE : To analyse whether specific attention is needed for the improvement of health for pregnant asylum seekers by producing an overview of obstetric outcomes, risk factors and expressed health needs of asylum seekers in the Netherlands and other Western host countries. DESIGN : Literature study. METHOD : A search was performed in Medline, Embase and PsycInfo for empirical studies about pregnancy and delivery specifically among asylum seekers in Western host countries and published since 1995. Picarta and the authors' literature collections were used to find Dutch studies. Google was used to find grey literature. RESULTS : Published empirical studies on pregnancy outcome indicators specific for asylum seekers were scarce and limited to the Netherlands. The studies found revealed an increased risk of perinatal and maternal mortality and severe maternal morbidity. These studies, however, were based on small numbers of cases. Qualitative studies revealed that pregnant asylum seekers expressed the following needs: a) information about pregnancy and about healthcare in the host country, b) healthcare professionals who pay attention to their problems and c) mothers' groups for social contacts and information exchange. CONCLUSION : Specific attention must be paid to improving the care for pregnant asylum seekers, since the limited number of studies suggest that asylum seekers are at increased risk of perinatal mortality, maternal mortality and severe maternal morbidity. More studies are needed into risk factors and quality of care for pregnant asylum seekers. The publications studied contain recommendations for an improved matching of the care with the needs expressed. The recommendations concern provision of information, cultural competencies of care providers, identification of risk factors, health networks approach, continuity of care and organising mother's groups