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. Conclusion: 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.