408 Delivering obstetric care to maritime migrants: the Lampedusa protocol

Abstract OP 6: Health Policy 2, B308 (FCSH), September 3, 2025, 15:45 - 16:45 Background While Lampedusa Island has long represented the “Doorway to Europe,” migration is considered an emergent phenomenon rather than a constant occurrence. Vulnerable populations – particularly pregnant women – require both routine and urgent medical services. We describe a novel approach to triaging pregnant migrant women, observed clinical presentations, and the effects on healthcare resource utilization. Methods The Lampedusa Protocol was implemented in March 2023 by the Agenzia Sanitaria Provinciale (ASP) of Palermo. Clinical and demographic data from 28 March 2023 to 31 May 2024 were collected and analyzed by cross-referencing the clinical databases of the policlinic of Lampedusa and the Italian Red Cross, the managing entity of the migrant Hotspot. Resource utilization data were collected from the helicopter transfer data recorded by the emergency medical service for the island. Associations between Multidimensional Global Poverty Index (MPGI) and need for helicopter evacuation were assessed using multivariable logistic regression. Our abstract and manuscript are currently under consideration for publication at the Journal of Migration and Health. Findings 571 pregnant patients were evaluated between 3/28/2023-5/31/2024. Patients represented 23 nationalities, average age was 26 years (SD = 6.6 years), and average ultrasound-estimated gestational age was 25.2 weeks (SD = 9.6 weeks). The most common causes for helicopter transfer were late gestational age or concern for, or symptoms of, labor. Compared to the pre-implementation period, the proportion of patients requiring any flight decreased by 23% (24.5% to 18.9%, p = 0.027) and the proportion requiring urgent flights decreased by 52% (8.3% to 4.0%, p = 0.003) in the post-implementation period. There was no association between MPGI of origin country and helicopter evacuation. Women with known nationality had reduced odds (OR = 0.49, 95% CI = 0.27-0.90, p = 0.02) of requiring urgent helicopter evacuation. Interpretation We demonstrate improved resource utilization with protocolized care pathways for maritime migrants in European borderlands.