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breastfeeding, pregnancy outcome, prenatal care, reproductive health, Roma



  1. Fernandez-Feito, Ana
  2. Bueno-Perez, Arancha
  3. Diaz-Alonso, Julian
  4. Paz-Zulueta, Maria
  5. Lana, Alberto


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: The aim of this study was to examine differences in prenatal care and maternal-infant outcomes between Roma and non-Roma women.


Methods: A retrospective longitudinal study was conducted in 122 pregnant women (28 Roma and 94 non-Roma women) recruited from 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 [appearance, pulse, grimace, activity, and respiration]) were collected from the electronic medical records. Prenatal care was assessed using three indices: 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 with non-Roma women, advanced maternal age (>=35 years) and primigravida were 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 index 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.