SUMMARYObjective: This study analyses the role of ethnicity-based birth weight differences at term (37-42 weeks) between neonates of Roma and nonRoma populations in Hungary, controlling for socio-demographic and biological characteristics of the mothers.Methods: A cross-sectional survey among 9,040 mothers coupled with biometric data of the neonates was conducted in 2010. Inclusion criteria were: at term (37-42 weeks gestation) non-pathological pregnancies, and self-reported ethnicity. Birth weight was based on mothers' ethnicity, age, body mass index, education, marital and employment status, poverty level, household amenities, dietary and smoking habits using multiple linear regression.Results: The mean difference between Roma and non-Roma neonates measured without controlling for possible confounding factors was −288.7 gram (p < 0.001, 95% CI = −313.4-263.9). In the linear regression model Roma neonates weighed on average 69.67 grams less than nonRoma neonates (p < 0.001, 95% CI = 30.51-108.83). The mother's underweight BMI, low education and smoking during pregnancy (p < 0.001), age under 18 years, no amenities of housing and insufficient consumption of fruits and dairy products also significantly influenced (p < 0.05) the neonates' birth weight.Conclusion: Roma ethnicity was independently correlated with lower birth-weight among at term neonates, controlling for known risk factors. Roma ethnicity may serve as a proxy for other unmeasured social or biological factors and should be considered an important covariate for measurement among neonates.

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Objectives: In Hungary, 37% of women living in poverty were smokers in 2012. There are no valid data of pregnant women's spontaneous smoking cessation.Methods: Our retrospective cohort study (2009)(2010)(2011)(2012) targeted the most underdeveloped regions with an estimated 6-8.5% of Roma population. The sample (N = 12,552) represented 76% of the target population i.e. women in four counties in a year delivering live born babies. Chi-square probe and multivariable logistic regression model (p < 0.05) were used to assess relationship between socio-demographic characteristics and spontaneous cessation.Results: Prior to pregnancy, the overall smoking rate was 36.8%. That of women in deep poverty and Roma was 49.7% and 51.1%, respectively. 70.3% of smokers continued smoking during the pregnancy. Among them 80.6% lived in deep poverty. Spontaneous quitting rate was 23.0%. Factors correlated with continued smoking included being Roma (OR = 1.95), undereducated (OR = 2.66), living in homes lacking amenities (OR = 1.48), and having regularly smoking partner (OR = 2.07). Cessation was promoted by younger age (≤ 18 years) (OR = 0.18), being married (OR = 0.50), and the first pregnancy.Conclusions: Tailored cessation programmes are needed for Roma, older, low-income, and multiparous women who are less likely to quit on their own. Engaging husbands/partners is essential to reduce smoking among pregnant women and second-hand smoke exposure.

SUMMARY Introduction The purpose of this research was to assess factors associated with quit attempts and successful smoking cessation among a sample of socioeconomically disadvantaged pregnant women living in Eastern Hungary. Materials and methods In-person interviews were conducted among 201 women residing in Eastern Hungary who self-identified as occasional or regular smokers at the time they learned they were pregnant. Results 54% of the women were smokers at the time they learned they were pregnant. Just over half tried to quit, but only 20% were successful. Factors associated with reduced likelihood of quit attempts included being a regular (vs. occasional) smoker (OR=0.36, 95% CI 0.13–1.00) and being Roma (vs. non-Roma) (OR=0.32, 95% CI 0.14–0.72). Women who completed high school were 7½ times more likely to quit (OR=7.5, 95% CI 1.68–33.2) and those who were employed were 7½ times more likely to quit (OR=7.6, 95% CI 1.88–30.35). Regular smokers were 88% less likely to quit than occasional smokers. Discussion Smoking cessation interventions targeting pregnant women are needed in Eastern Hungary. Efforts to integrate smoking cessation into the current excellent pre-natal care and health visitor program will reach most women who are pregnant or who have given birth within the preceding 3 years.

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