Demographic and clinical associations with miscarriage and unsuccessful conception attempts among female Syrian refugees in Lebanon

Abstract

Background: Female Syrian refugees in Lebanon face poor sexual reproductive health outcomes. However, associated risk and protective factors are not clearly understood. This study focuses on examining sociodemographic and clinical factors associated with miscarriage and unsuccessful conception among this population.

Methods: This cross-sectional study is part of the Self-Efficacy and Knowledge Trial, which aims to enhance SRH and family planning among Female Syrian refugees in humanitarian settings. This baseline data (n = 485) was collected from 2 primary healthcare centers in the Bekaa in Lebanon using the PAPFAM tool during November and December 2023. Statistical analyses included chi-square tests, ANOVA, independent t-tests, and multivariate logistic regression to identify associations between sociodemographic and clinical factors and SRH outcomes.

Results: Miscarriage and unsuccessful conception attempts were relatively high in our sample. Higher male partnered refugee age and lack of pregnancy desire were significant risk factors for miscarriage (OR:1.058; CI: 1.008- 1.110 and OR:5.190; CI: 1.031 - 26.112 respectively), while frequent antenatal care visits were protective (OR:0.923; CI: 0.855 - 0.997). Miscarriage was not associated with women's age, and education. Unsuccessful conception attempts were significantly associated with higher male partnered refugee age (OR: 1.086; CI: 1.031 - 1.144), higher maternal age at first pregnancy (OR: 1.345; CI: 1.063 - 1.725), and lower number of alive children (OR: 0.436; CI: 0.313 - 0.607). No significant associations were found between unsuccessful conception attempts and screening, education, employment, and financial/transportation barriers to seeking healthcare services.

Conclusion: Findings highlight the need for community-based interventions to address modifiable risk factors for miscarriage and unsuccessful conception among female Syrian refugees as described in detailed in the manuscript. This may include strengthening access to antenatal care, promoting family planning and optimal communication strategies, and addressing social and environmental determinants to mitigate related risk factors. Additionally, efforts should focus on improving SRH literacy and facilitating professional healthcare consultations and screenings.

Keywords: Infertility; Lebanon; Miscarriage; Pregnancy Syrian refugees; Reproductive health; Sexual health.