The effect of psycho-social factors on birth outcomes among the refugee pregnant women in gaza strip

Over the past ten years, infant mortality and neonatal mortality rates in Gaza Strip had an increasing trend despite all the efforts that were done to reduce it. This study aimed to examine the effects of exposure of Palestinian refugee women to psychosocial stressing factors during the 3rd trimester of pregnancy and consequently their birth outcomes in Gaza Strip. A prospective cohort study was applied on 500 pregnant (aged above 18 and less than 39) women in their third trimester attended eight health centers to receive antenatal care using an interview questionnaire. After delivery women were approached to collect information about their birth outcomes. Statistical analysis was done by SPSS (version 20). Chi-square analysis test was used to describe the study variables and univariate analysis was done to examine the association between the study independent variables and the birth outcomes (P-value ≤ 0.05). The results showed that (21.2)% of the babies; their weight were less than 2500 and (16.4)% were preterm babies. Also, (1.6)% of the woman experienced perinatal deaths. More than half of low birth weight, preterm babies, and perinatal deaths were among the women who completed secondary and high school. Also, In addition, (7)% of low birth weight and (8)% of PTB were to employed pregnant women. About (16)% of pregnant women were exposed to domestic violence during their pregnancy. Some of those women had adverse birth outcomes, results demonstrated that domestic violence contributes to (18.9)% of low birth weight babies, (17.1)% of preterm babies. Yet there wasn’t any perinatal death occurred among the women who were exposed to domestic violence. A (17.4)% of pregnant women perceived that they have received low social support and (43.2) % of them had high stress level. Also, (45.6)% complained of severe level of fatigue and (16)% had high stress level caused by pregnancy. There were significant associations between the husband’s education and having preterm babies and the relationship of the women with their husbands and having low birth weight babies or preterm babies. In conclusion, Although social support; violence; fatigue; having stress due to pregnancy or exposed to any kind of other stress did not show significant roles in determining birth outcomes in this study, but is still considered factors affecting pregnant women’s health.