Non-medical determinants of perinatal health: protocol for a systematic review with meta-analysis

Daalderop, Leonie A; Groot, Marjolein W de; Meer, Lindsey van der; Steegers, Eric A.P.; Bertens, Loes C. M.

doi:10.1136/bmjopen-2019-031437

Cited by 1 publication

(2 citation statements)

References 26 publications

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“…Another strength is that we included protective factors, while most studies focus primarily on factors that increase the risk of adverse outcomes and less on protective factors that might counteract these effects. 18 , 19 Unfortunately, data on topics such as nutrition, stress, health literacy, preconception care and adverse childhood experiences were not available, while these factors could provide additional insights into vulnerability. Next, using largest posterior probability to assign women to classes is a limitation, because not all women are fully representative of one class only.…”

Section: Discussionmentioning

confidence: 99%

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Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis

Molenaar

Meer

Bertens

et al. 2022

European Journal of Public Health

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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.

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Section: Discussionmentioning

confidence: 99%

“… 11 , 17 , 18 Previous studies frequently explored the association between a limited number of predetermined, single risk factors and adverse birth outcome, but neglected co-existence of both protective- and risk factors that can influence outcomes. 12 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%