# Caesarean Section Rates Among Syrian Refugees in Lebanon

## TL;DR

This study examines the rise in C-section rates among Syrian refugees in Lebanon, linking it to factors like maternal age and gestational age.

## Contribution

The study provides new insights into how displacement and healthcare access affect C-section rates among Syrian refugee women in Lebanon.

## Key findings

- C-section rates among Syrian refugees in Lebanon doubled compared to pre-war Syria.
- Maternal age, gestational age, and baby's sex were significantly associated with higher C-section rates.
- Refugee C-section rates are lower than those of the Lebanese population but still exceed WHO recommendations.

## Abstract

Objectives: Deliveries can be complicated by many factors, especially if women are not well followed up. Syrian refugees, for the last decade, have had to go through unbearable circumstances, which have affected their health. This is evident in the pregnancy data when we look at the delivery methods and outcomes. The caesarian section (C-section) rate among Syrians before the civil war was as per the WHO recommendation; this rate, however, changed enormously for the Syrian refugees in Lebanon. This study aims to determine the C-section rate among Syrian refugees in Lebanon, identify contributing factors, and compare it to pre-war Syrian rates.

Study design: This retrospective study featuring a sample size of 2183 women was conducted in a government hospital, where refugees are hospitalized under the coverage of the United Nations High Commissioner for Refugees ( UNHCR). The studied variables include the mode of delivery, maternal age, parity, day of the week, maternal hospital stay, gestational age, sex of the baby, and weight of the baby.

Results: The C-section rate increased dramatically after the displacement of the refugees to Lebanon. This increase, however, is significantly lower than the rate among the Lebanese population. The main variables associated with an elevated C-section rate were maternal age (p-value <0.0001), day of the week (p-value <0.0001), gestational age (p-value <0.0001), and male babies (p-value = 0.024). Furthermore, C-section was associated with a longer hospital stay.

Conclusion: The C-section rate among Syrian refugees in Lebanon increased dramatically compared to the C-section rate in the Syrian population before the war. This increase is double the optimal rate recommended by the WHO.