SELF-RATED HEALTH AND TEENAGE PREGNANCIES IN ROMA WOMEN: INCREASING HEIGHT IS ASSOCIATED WITH BETTER HEALTH OUTCOMES

Perinatal health outcomes of women from Gypsy, Roma and Traveller communities: A systematic review

BACKGROUND

GRT communities are disadvantaged minority groups in Europe and experience some of the poorest health outcomes, including maternal and child health. This systematic review aimed to assess the maternal, perinatal and infant health outcomes of women from GRT communities and the factors associated with the reported outcomes.

METHODS

Database searches were conducted from inception to June 2023 in 4 bibliographic databases supplemented with an additional Google Scholar search. Studies with quantitative data on maternal outcomes published in English were considered. A narrative synthesis was performed, and data were presented in text, figures and tables.

FINDINGS

Forty-five studies from 13 European countries were included. Outcome factors related to mothers showing low healthcare engagement, high fertility rates and shorter gestation periods among GRT women. Child wantedness was also noted to influence pregnancy completeness, which included abortion and miscarriage. More negative infant outcomes were seen in GRT infants than non-GRT infants; this included higher preterm births, lower birth weight, higher rates of intrauterine growth restriction and infant mortality. Risk factors of poorer maternal outcomes were early reproduction, education, smoking, alcohol consumption, deprivation, poor nutrition and perinatal care.

CONCLUSION

This review provides evidence that GRT women and children experience more negative outcomes than general populations. It also highlights the gaps in ethnicity and health inequalities more broadly. The significant importance of this research is the need for increased focus on reducing health inequalities, especially among the GRT community.

Maternal age at marriage and child nutritional status and development: evidence from Serbian Roma communities

OBJECTIVE

This study aimed to assess whether maternal age at first marriage is associated with nutritional and developmental penalties in Roma children.

DESIGN

Roma nationally representative population-based study. Proxies for child nutritional outcomes included children's individual-level height-for-age z (HAZ) and weight-for-age z (WAZ) scores, HAZ and WAZ scores below two standard deviations from the median of WHO's reference population (children aged 0-59 months), and Early Child Development (children aged 36-59 months). Multiple and logistic regressions were used to estimate the association between maternal age at marriage and the outcomes, and other sociodemographic determinants as possible confounders.

SETTING

Aggregated data from UNICEF's fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements.

SUBJECTS

Children (n= 2652) aged 0-59 months born to ever-married women aged 15-48.

RESULTS

64% of women married before age 18, 19% of children were stunted, 9% wasted, and Early Child Development score was low. Maternal age at first marriage was not associated with either nutritional status or early development of Roma children. Weight at birth (children aged 0-24) emerged as the main predictor of children's nutritional status. Boys were more likely to be shorter, more stunted and wasted than girls. Child's age, maternal parity and unimproved toilet facility negatively impacted nutritional status, while maternal literacy mitigated against poor nutritional and developmental outcomes.

CONCLUSIONS

Roma children up to 5 years of age bear no negative consequences of maternal early marriage. The underlying determinants of children's wellbeing include improved sanitation, child characteristics, maternal literacy and reproductive behavior, and parental investment.

The Effect of Physical and Mental Health and Health Behavior on the Self-Rated Health of Pregnant Women

Self-rated health (SRH) is an evaluation tool to assess an individual's level of health, including both general health and personal experience. There have been existing studies on women's SRH; however, few studies have been on pregnant women's SRH and its associated factors. This study investigated the SRH of pregnant women and their factors using the Korea Community Health Survey. The chi-squared test and multivariable logistic regression were used to investigate the effects of demographic, physical, and mental health and health behaviors on the SRH of pregnant women. As a result of the study, 54.0% out of 1032 pregnant women had good SRH. Their SRH score was good when they were young, economically active, and living in cities. Poor SRH was observed with depression, hypertension, and after experiencing a fall. Good SRH was found when they exercised and slept for more than 8 h a day. This study is the first to observe the SRH of pregnant women and its related factors in South Korea.

The Differential Impact of Religion on Self-Reported Health Among Serbian Roma Women

The present paper offers an account of how self-reported health varies with religious affiliation and reproductive effort among Serbian Roma women. Data were collected in 2014-2018 in two Roma semi-urban settlements in central Serbia. The sample consisted of 177 Christian and 127 Muslim women, averaging 54 years of age. In addition to religious affiliation (Christianity/Islam), demographic data, reproductive histories, data on self-reported and children's health were collected, along with height and weight, and smoking status. Christian and Muslim Roma women differed significantly on a number of variables, with Muslim women reporting poorer health and higher reproductive effort. Among Roma women religion may be an important determinant of reproductive and fertility patterns, largely because it may have formed an important foundation upon which identity is based. This study adds to the literature on the cross-cultural relevance of the ways religion shapes reproductive behaviors for understanding the health variations of women from the same ethnic group who profess different religions.

Stature and education among Roma women: taller stature is associated with better educational and economic outcomes

The association between body height and educational outcome, as measured by years of completed schooling, was investigated among Roma women in Serbia in 2014-2018. Height, demographic data, level of schooling and reproductive histories were collected from 691 Roma women aged between 16 and 80 years living in rural settlements in central and western Serbia. Multinomial logistic regression analysis showed that short stature was associated with an increased risk of low education, possibly as a result of poor growth and developmental disadvantage in early life. Roma cultural practices were also shown to influence the school achievement of these Roma girls: in addition to height, education was positively associated with a higher bride price and better socioeconomic status, as acquired through marriage. For Roma women, height might influence not only their level of education but also their lifetime prospects.

Influence of maternal height on children's health status and mortality: A cross-sectional study in poor Roma communities in rural Serbia

To determine possible variations in children's health status and mortality associated with variations in maternal stature, an anthropometric and demographic study was conducted in a Roma population of poor socio-economic status in rural Serbia. Data were collected during several years of anthropological fieldwork. The sample consisted of 691 women, ranging from 16 to 80 years of age. In addition to stature, Roma women's demographics, reproductive history, reproductive outcomes and health status of their children were collected. The results provide evidence of a significant association between mother's stature and their children's health and mortality, with a shorter mother's stature predisposing children to poor health and survival outcomes. The findings could prompt development of a definition of short stature among Roma women to evaluate the risk based on height distribution among the general Roma population.