Risk factors for miscarriage among Syrian refugee women living outside of camps in Jordan: results from the Women ASPIRE cross-sectional study – Jordan


Maysa M. Khadra, Haya H. Suradi, Justin Z. Amarin, Nabila El-Bassel, Neeraj Kaushal, Ruba M. Jaber, Raeda Al-Qutob and Anindita Dasgupta


Background: Syrian refugee women face health care disparities and experience worse pregnancy outcomes, including miscarriages. We studied risk factors for miscarriage among Syrian refugee women living outside camps in Jordan to identify targets for interventions.

Methods : We analyzed data from Women ASPIRE, a cross-sectional study of gender-related physical and mental health issues of 507 Syrian refugee women (≥18 years old) living in non-camp settings in Jordan. We recruited women using systematic clinical sampling at four clinics. We limited our analyzes to women who had a history of pregnancy and whose most recent pregnancy was single, occurred in Jordan, and ended in term live birth or miscarriage (N = 307). We grouped the women according to the primary endpoint (term live birth or miscarriage) and compared the sociodemographic and clinical characteristics of the two groups. We used Pearson’s χ test or Mann–Whitney U test to obtain unadjusted estimates and multivariate binomial logistic regression to obtain adjusted estimates.

Results: The most recent pregnancies of 262 women (85%) ended in a live birth at term and 45 others (15%) in a miscarriage. Since their stay in Jordan, 11 women (4%) had not received reproductive health services. Of 35 women aged ≥ 35 years, not pregnant and not wishing to have a child (or otherwise), nine (26%) were not using contraception.

Of nine pregnant women aged ≥ 35 years, seven (78%) had not planned pregnancy. The adjusted odds of miscarriage were higher in women who had been diagnosed with thyroid disease (aOR, 5.54; 95% CI, 1.56 to 19.07), had been of advanced maternal age ( ORa, 5.83; 95% CI, 2.02-16.91), and had not received antenatal care (ORa, 36.33; 95% CI, 12.04-129.71). Each additional previous miscarriage predicted an increase in the adjusted odds of miscarriage by a factor of 1.94 (1.22–3.09).

Conclusion : We identified several risk factors for miscarriage among Syrian refugee women living outside camps in Jordan. Risk factors may lend themselves to preconception and prenatal care

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