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Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00737-024-01554-x","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T17:51:38Z","timestamp":1737136298000},"page":"699-709","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Integrated care for multi-domain vulnerability during pregnancy: a retrospective cohort study"],"prefix":"10.1007","volume":"28","author":[{"given":"Sushma C.","family":"Munshi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eline C. 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The Medical Ethics Committee of Erasmus Medical Centre declared this study exempt of Medical Research Involving Human Subjects Act (also known as WMO) (protocol no. MEC-2020\u20130852).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"As this was a retrospective study based on pseudonymized information retrieved from medical charts, no informed consent was retrieved from participants. That is, prior to analysis, personal data were replaced by a study number (pseudonymization). The medical charts were only accessed by two members of the medical team directly involved in care, who pseudonymized the data after extraction. This procedure was approved by the Medical Ethics Committee of Erasmus Medical Centre and is in line with legal regulation in the Netherlands, which obligates hospitals to routinely evaluate provided care and outcome of this care for the purpose of safety and quality of care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors have no relevant financial or non-financial interest to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}]}}