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Fetal growth restriction and maternal smoking in the Macedonian Roma population: a causality dilemma

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Macedonia is one of the top five countries globally in reported smoking rates. Over 10 % of the population consists of the underprivileged Roma minority. We aimed to determine whether Roma ethnicity is an independent risk factor for adverse pregnancy outcome or merely mediating maternal smoking.

Methods

Maternal data were retrieved from the perinatal computerized database for all deliveries during 2007–2011 at the only Clinical Hospital in Bitola, Macedonia. Multivariable regression models were constructed to control for confounders.

Results

Of nearly 7,000 deliveries, 8.65 % were of maternal Roma ethnicity and 40 % of the Romani women admitted to regularly smoke during pregnancy. Both Roma ethnicity and maternal smoking were significantly associated with the absence of maternal education, history of abortions and intra uterine growth restriction (IUGR) in the univariate analysis. Both maternal Roma ethnicity (OR 2.46, 95 % CI 1.79–3.38) and smoking status (OR 1.37, 95 % CI 1.02–1.85) were found to be independent predictors of IUGR using the multivariate analysis. Lower birthweight and smaller head circumference were both independently associated with Roma ethnicity and smoking.

Conclusions

Underprivileged ethnic background is a significant risk factor for IUGR, independent of maternal smoking status. To the best of our knowledge, this is the first publication focusing on pregnancy outcome in Romani Macedonian parturients.

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Conflict of interest

The authors report no conflict of interests. This study was not funded. The authors state they have had full control of all primary data and that they agree to allow the Journal to review their data if requested.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel

    Asnat Walfisch & Mordechai Hallak

  2. University Clinic of Obstetrics and Gynecology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia

    Asnat Walfisch, Sotir Nikolovski & Bilijana Talevska

  3. Clinical Hospital Dr. Trifun Panovski, Bitola, Republic of Macedonia

    Sotir Nikolovski & Bilijana Talevska

Authors
  1. Asnat Walfisch
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  2. Sotir Nikolovski
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  3. Bilijana Talevska
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  4. Mordechai Hallak
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Correspondence to Asnat Walfisch.

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Walfisch, A., Nikolovski, S., Talevska, B. et al. Fetal growth restriction and maternal smoking in the Macedonian Roma population: a causality dilemma. Arch Gynecol Obstet 287, 1131–1136 (2013). https://doi.org/10.1007/s00404-013-2731-1

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  • DOI: https://doi.org/10.1007/s00404-013-2731-1

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