title: Somali women's use of maternity health services and the outcome of their pregnancies: a descriptive study comparing Somali immigrants with native-born Swedish women.
abstract: OBJECTIVE
  To describe how Somali immigrant women in a Swedish county use the antenatal care and health services, their reported and observed health problems and the outcome of their pregnancies.
  
  
  METHODS
  Retrospective, case-control study, comparing data obtained from the records of antenatal and obstetric care for Somali born women with the same data for parity matched women born in Sweden giving birth between 2001 and 2009.
  
  
  METHODS
  Utilisation of antenatal health care (timing and number of visits), pregnancy complications (severe hyperemesis, anaemia, preeclampsia), mode of birth (normal vaginal, operative vaginal, caesarean), and infant outcomes (preterm birth, birth weight, and perinatal mortality).
  
  
  RESULTS
  Compared to the 523 Swedish-born women the 262 Somali women booked later and made less visits for antenatal care. They were more likely to have anaemia, severe hyperemesis and a few patients were found to have very serious health conditions. Emergency caesarean section (OR 1.90, CI 1.16-3.10), especially before start of labour (OR 4.96, CI 1.73-14.22), high perinatal mortality with seven versus one perinatal deaths and small for date infants (OR 2.95, CI 1.49-5.82) was also more prevalent.
  
  
  CONCLUSIONS
  Pregnant Somali immigrant women still constitute a vulnerable group, which implicates that there is a missing link in the surveillance system that needs attention. There is an increased risk for intrauterine foetal death, small for date and low birth weight infants as well as serious maternal morbidity.
authors.affiliation: Department of Obstetrics and Gynaecology, Falun Hospital, Falun, Sweden; Center for Clinical Research, Dalarna, Sweden. Electronic address: eva-britta.rassjo@ltdalarna.se.
authors.forename: Eva Britta
authors.initials: EB
authors.lastname: Råssjö
authors.forename: Ulrika
authors.initials: U
authors.lastname: Byrskog
authors.forename: Raghad
authors.initials: R
authors.lastname: Samir
authors.forename: Marie
authors.initials: M
authors.lastname: Klingberg-Allvin
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology; D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010342:Patient Acceptance of Health Care; D054238:Perinatal Mortality; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D047928:Premature Birth; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012998:Somalia / Q000208:ethnology; D013548:Sweden / Q000453:epidemiology; D014839:Vomiting / Q000453:epidemiology; D055815:Young Adult
keywords: Case control study; Health care utilisation; Maternal morbidity; Perinatal outcome; Somali women