Evidence map›Paper›PMID 36041781›Full record

ArticleBMJ global health2022

Protracted armed conflict and maternal health: a scoping review of literature and a retrospective analysis of primary data from northwest Syria.

Sara Basha, Alex Socarras, Mohammed Waseem Akhter, Mohamed Hamze, Ahmad Albaik, Imad Hussein, Ahmad Tarakji, Mufaddal Hamadeh, Randa Loutfi, Mazen Kewara and 2 more

Abstract readScoping Review
In one paragraph

Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sara BashaSchool of Medicine, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-0998-7310
Alex SocarrasSyrian American Medical Society, Washington, District of Columbia, USA.
Mohammed Waseem AkhterSyrian American Medical Society, Washington, District of Columbia, USA.
Mohamed HamzeSyrian American Medical Society, Gaziantep, Turkey.
Ahmad AlbaikSyrian American Medical Society, Gaziantep, Turkey.
Imad HusseinSyrian American Medical Society, Gaziantep, Turkey.
Ahmad TarakjiSyrian American Medical Society, Washington, District of Columbia, USA.
Mufaddal HamadehSyrian American Medical Society, Washington, District of Columbia, USA.
Randa LoutfiSyrian American Medical Society, Washington, District of Columbia, USA.
Mazen KewaraSyrian American Medical Society, Gaziantep, Turkey.
Fares AlahdabSyrian American Medical Society, Washington, District of Columbia, USA.
Aula AbbaraSyrian American Medical Society, Washington, District of Columbia, USA a.abbara15@ic.ac.uk.ORCID 0000-0002-7049-8399

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSyria's protracted conflict has devastated the health system reversing progress made on maternal health preconflict. Our aim is to understand the state of maternal health in Syria focused on underage pregnancy and caesarean sections using a scoping review and quantitative analysis; the latter draws on data from the Syrian American Medical Society's (SAMS) maternal health facilities in northwest Syria.

methodsWe performed a scoping review of academic and grey literature on the state of maternal health across Syria since the onset of conflict (taken as March 2011). Identified articles were screened using pre-established criteria and themes identified. We also performed a retrospective quantitative analysis of maternal health data from SAMS' facilities in a microcontext in north-west Syria between March 2017 and July 2020, analysing the trends in the proportion of births by caesarean section and age at pregnancy.

resultsScoping review: of 2824 articles, 21 remained after screening. Main themes related to maternal mortality rates, caesarean sections, maternal age and perinatal care. 12 studies reported caesarean section rates; these varied from 16% to 64% of all births: northern Syria (19%-45%,) Damascus (16%-54%,) Lattakia (64%) and Tartous (59%.) Quantitative analysis: Of 77 746 births across 17 facilities, trend data for caesarean sections showed a decrease from 35% in March 2017 to 23% in July 2020 across SAMS facilities. Girls under 18 years accounted for 10% of births and had a lower proportion of caesarean section births. There was notable geographical and interfacility variation in the findings.

conclusionThe quality of available literature was poor with country-level generalisations. Research which explores microcontexts in Syria is important given the different effects of conflict across the country and the fragmented health system. Our quantitative analysis provides some evidence around the changes to caesarean section rates in northwest Syria. Despite limitations, this study adds to sparse literature on this important topic.

Indexed as

Cesarean SectionMaternal HealthAdolescentArmed ConflictsFemaleHumansPregnancyRetrospective StudiesSyriaMaternal healthObstetricsPublic HealthSurgery

Identifiers

PMID36041781
PMCPMC9438041

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.