Prenatal and birth care of Roma women

Abstract

Background The reproductive health of Roma women has been poorly studied. It is important to determine the follow-up care received by Roma women from pregnancy to the first postpartum visit, together with neonatal outcomes, to improve prenatal care and maternal-child outcomes.

Objective To examine differences in prenatal care and maternal-infant outcomes between Roma and non-Roma women.

Methods A retrospective longitudinal study of 122 pregnant women (28 Roma and 94 non-Roma women) was recruited in seven primary care centers in three districts of Asturias (Spain). Sociodemographic variables, prenatal control, birth characteristics, feeding, and neonatal outcomes (gestational age, weight, and APGAR) were collected from the electronic medical records. Prenatal care was assessed using three indexes: the Kessner index, the Modified Adequacy of Prenatal Care Utilization Spanish Index, and an ad-hoc index that considered adherence to the recommendations for pregnant women in Spain.

Results Compared to non-Roma women, advanced maternal age (≥ 35 years) and primigravida was less common among Roma women. Roma women visited the dentist less often, smoked more, and underwent group B streptococcus screening less frequently. No differences were found in the number of prenatal visits between Roma and non-Roma women. Consequently, there were no differences between the Kessner and the Modified Adequacy of Prenatal Care Utilization Spanish Index. Using the ad-hoc index, the non-Roma women more frequently had adequate prenatal visits. There were no differences in birth characteristics, type of feeding, and neonatal outcomes.

Discussion Overall, prenatal care was slightly worse in Roma women; however, this did not imply worse neonatal health outcomes. Both study groups had similar birth characteristics and immediate puerperium, including feeding.