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Randomized Controlled Trial
. 2020 Dec 31;13(1):1794107.
doi: 10.1080/16549716.2020.1794107.

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area - a population-based study

Anna Akselsson  1 , Helena Lindgren  2 , Susanne Georgsson  3   4 , Karin Pettersson  4 , Viktor Skokic  5 , Ingela Rådestad  1
Affiliations
Randomized Controlled Trial

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area - a population-based study

Anna Akselsson et al. Glob Health Action. .

Abstract

Background: Studies report that women born in some African countries, after migrating to the Nordic countries, have worse pregnancy outcomes than women born in the receiving countries. With the aim of identifying unmet needs among Somali-born women, we here study this subgroup.

Objective: We compared pregnancy outcomes among women born in Somalia to women born in Sweden. Further, we investigated whether the proactive maternal observation of fetal movements has effects on birth outcomes among women born in Somalia.

Methods: In Stockholm, half of the maternity clinics were randomized to intervention, in which midwives were instructed to be proactive towards women by promoting daily self-monitoring of fetal movements. Data for 623 women born in Somalia and 26 485 born in Sweden were collected from a population-based register.

Results: An Apgar score below 7 (with stillbirth counting as 0) at 5 minutes was more frequent in babies of women born in Somalia as compared to babies of women born in Sweden (RR 2.17, 95% CI 1.25-3.77). Babies born small for gestational age were more common among women born in Somalia (RR 2.22, CI 1.88-2.61), as were babies born after 41 + 6 gestational weeks (RR 1.65, CI 1.29-2.12). Somali-born women less often contacted obstetric care for decreased fetal movements than did Swedish-born women (RR 0.19, CI 0.08-0.36). The differences between women born in Somalia and women born in Sweden were somewhat lower (not statistically significant) among women allocated to proactivity as compared to the Routine-care group.

Conclusions: A higher risk of a negative outcome for mother and baby is seen among women born in Somalia compared to women born in Sweden. We suggest it may be worthwhile to investigate whether a Somali-adapted intervention with proactivity concerning self-monitoring of fetal movements may improve pregnancy outcomes in this migrant population.

Keywords: Apgar score; Fetal movements; Mindfetalness; awareness of fetal movements; stillbirth.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Flow chart.
Figure 2.
Figure 2.
A comparison in obstetric and birth outcomes between women from Somalia and Sweden.
See this image and copyright information in PMC

References

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