Journal article
Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis
- Abstract:
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Background Early detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children’s development and health. We aimed to identify classes of vulnerability among pregnant women in the Netherlands using pre-pregnancy data on a wide range of social risk and protective factors, and validate these classes against the risk of adverse outcomes.
Methods We conducted a latent class analysis based on 42 variables derived from nationwide observational data sources and self-reported data. Variables included individual, socioeconomic, lifestyle, psychosocial and household characteristics, self-reported health, healthcare utilization, life-events and living conditions. We compared classes in relation to adverse outcomes using logistic regression analyses.
Results In the study population of 4172 women, we identified five latent classes. The largest ‘healthy and socioeconomically stable’-class [n = 2040 (48.9%)] mostly shared protective factors, such as paid work and positively perceived health. The classes ‘high care utilization’ [n = 485 (11.6%)], ‘socioeconomic vulnerability’ [n = 395 (9.5%)] and ‘psychosocial vulnerability’ [n = 1005 (24.0%)] were characterized by risk factors limited to one specific domain and protective factors in others. Women classified into the ‘multidimensional vulnerability’-class [n = 250 (6.0%)] shared multiple risk factors in different domains (psychosocial, medical and socioeconomic risk factors). Multidimensional vulnerability was associated with adverse outcomes, such as premature birth and caesarean section.
Conclusions Co-existence of multiple risk factors in various domains is associated with adverse outcomes for mother and child. Early detection of vulnerability and strategies to improve parental health and well-being might benefit from focussing on different domains and combining medical and social care and support.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 951.4KB, Terms of use)
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- Publisher copy:
- 10.1093/eurpub/ckac170
Authors
- Publisher:
- Oxford University Press
- Journal:
- European Journal of Public Health More from this journal
- Volume:
- 33
- Issue:
- 1
- Pages:
- 25–34
- Place of publication:
- England
- Publication date:
- 2022-12-14
- DOI:
- EISSN:
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1464-360X
- ISSN:
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1101-1262
- Pmid:
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36515418
- Language:
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English
- Keywords:
- Pubs id:
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1315417
- Local pid:
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pubs:1315417
- Deposit date:
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2023-03-07
Terms of use
- Copyright holder:
- Molenaar et al.
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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