{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:52:19Z","timestamp":1793163139093,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Dutch Ministry of Health, Welfare and Sport"},{"name":"National Institute for Public Health and the Environment","award":["V\/010038\/01"],"award-info":[{"award-number":["V\/010038\/01"]}]},{"name":"National Institute for Public Health and the Environment","award":["V\/060438\/22"],"award-info":[{"award-number":["V\/060438\/22"]}]},{"name":"National Institute for Public Health and the Environment","award":["NET-2017-096"],"award-info":[{"award-number":["NET-2017-096"]}]},{"DOI":"10.13039\/501100001826","name":"Netherlands Organization of Health Research and Development","doi-asserted-by":"crossref","award":["554002006"],"award-info":[{"award-number":["554002006"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Early detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000\u2009days, a crucial period for children\u2019s 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the study population of 4172 women, we identified five latent classes. The largest \u2018healthy and socioeconomically stable\u2019-class [n\u2009=\u20092040 (48.9%)] mostly shared protective factors, such as paid work and positively perceived health. The classes \u2018high care utilization\u2019 [n\u2009=\u2009485 (11.6%)], \u2018socioeconomic vulnerability\u2019 [n\u2009=\u2009395 (9.5%)] and \u2018psychosocial vulnerability\u2019 [n\u2009=\u20091005 (24.0%)] were characterized by risk factors limited to one specific domain and protective factors in others. Women classified into the \u2018multidimensional vulnerability\u2019-class [n\u2009=\u2009250 (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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckac170","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T12:57:22Z","timestamp":1671022642000},"page":"25-34","source":"Crossref","is-referenced-by-count":23,"title":["Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8025-040X","authenticated-orcid":false,"given":"J M","family":"Molenaar","sequence":"first","affiliation":[{"name":"Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services , Bilthoven, the Netherlands"},{"name":"Department of 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Vries","sequence":"additional","affiliation":[{"name":"Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services , Bilthoven, the Netherlands"},{"name":"Department of Public Health and Primary Care\/Health Campus The Hague, Leiden University Medical Centre , the Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-3622","authenticated-orcid":false,"given":"A J M","family":"Waelput","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre , Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"M","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care\/Health Campus 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