Prevalence of Preterm Birth in a Marginalized Roma Population-Quantitative Analysis in One of the Most Disadvantaged Regions of Hungary.

Preterm birth is a leading cause of perinatal morbidity and mortality and is particularly prevalent among socially disadvantaged female populations. This quantitative, cross-sectional study aimed to explore the prevalence of preterm birth in three segregated Roma communities in Hungary and to identify health behavior and care factors associated with its occurrence. In our study, preterm birth was defined as delivery before 37 completed weeks of gestation (i.e., <259 days). Data were collected from 231 Roma women living in three municipalities of Szabolcs-Szatmár-Bereg County, one of Hungary's most disadvantaged regions, using a structured interview questionnaire. The participants were women aged 18-65 years. Of these, 209 had been pregnant at least once in their lifetime. The questionnaire covered socio-demographic characteristics (age, level of education, employment status, housing conditions, marital status), health behaviors (smoking, alcohol consumption, drug use, vitamin supplementation, other substance use), antenatal care attendance, and birth outcomes (preterm birth, gestational age, low birth weight, newborn status). Statistical analyses included descriptive statistics, chi-square tests, and binary logistic regression with significance set at < 0.05. Preterm birth was significantly more common among women who smoked, consumed alcohol or drugs during pregnancy, or had vaginal infections. Drug use showed the strongest association with a 22-fold increase in risk, followed by alcohol (nearly fivefold), smoking (over threefold), and infections (threefold). Although non-attendance at antenatal care was associated with increased risk, this relationship was not statistically significant. In the multivariate logistic regression model, alcohol consumption (OR = 1.744, < 0.01), smoking (OR = 2.495, < 0.01), drug use (OR = 25.500, < 0.001), and vaginal infections (OR = 4.014, < 0.01) during pregnancy were independently associated with an increased risk of preterm birth, whereas folic acid supplementation (OR = 0.448, < 0.05) showed a significant protective effect. These findings highlight that preterm birth is intricately linked to socioeconomic disadvantage and adverse health behaviors. Culture-specific, community-based prevention strategies are essential to reduce perinatal risks in marginalized populations.