Risk factors of preterm birth and low birth weight babies among Roma and non-Roma mothers: a population-based study.
BACKGROUND
In 2009, 8.4% of live births in Hungary were low birth weight (LBW) and 8.7% were preterm (PTB). Roma are disproportionately represented in Northern Hungary where LBW and PTB are highest in the country (10.3% equally). This study evaluates the risk factors for LBW and/or PTB among the Roma and non-Roma populations in two Northern Hungarian counties.


METHODS
We conducted a retrospective cohort study of 5469 non-Roma and 2287 Roma mothers who gave birth in 2009. Women were visited by the Maternal and Child Health Service nurses and completed in-person structured surveys on demographic, socio-economic, cultural and lifestyle factors. These data were combined with biometric data from hospital records. Bivariate statistics and a logistic regression analyses were used to determine risk factors for LBW and PTB.


RESULTS
Roma had a higher incidence of PTB and LBW babies compared with non-Roma women (PTB 9.9% vs. 7.1%, LBW 12.2% vs. 6.5% P = 0.001). However, ethnicity was not related to PTB and LBW in multivariable analyses, when controlling for socio-demographic and lifestyle characteristics. Factors associated with LBW and PTB include being underweight, advanced maternal age, and smoking.


CONCLUSIONS
Strategies that ensure healthy lifestyles must be well integrated in family-based interventions and in the schools, with special consideration for Roma women who have a higher prevalence of deleterious lifestyles and poor birth outcomes. Ensuring a healthy body weight and no smoking has important implications for the mother and foetus.
Institute of Public Health, Semmelweis University, Budapest, Hungary. balazs-peter@windowslive.com
Péter
P
Balázs
Ildikó
I
Rákóczi
Andrea
A
Grenczer
Kristie L
KL
Foley
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001699:Biometry; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007230:Infant, Low Birth Weight; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008423:Maternal Age; D008430:Maternal-Child Health Centers; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D047928:Premature Birth / Q000453:epidemiology*; D011295:Prenatal Care / Q000523:psychology / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors