Joyce Molenaar

37 Defining vulnerability subgroups among pregnant women Figure 1. A visual representation of the five latent classes, described across the nine themes that summarize all 42 factors related to vulnerability. The vertical axis displays for each theme the average proportion of women within the categories that represent the risk factors (each first category in Table 2). A higher score means that a higher proportion of women in a class have risk factors to vulnerability. An example: the theme ‘self-reported health’ consists of three factors: perceived health, long-term illness and restriction by health. For Class 1 (multidimensional vulnerability), the average proportion of women with a negative perceived health (0.7), long-term illness (0.68) and feelings of being restricted by health (0.76), is 0.71. This average proportion is displayed. Class 1 (n = 250; 6.0%), was characterized by high proportions of almost all risk factors to vulnerability. Women in this class were likely to receive social benefits or to have no income (proportion of 0.62) and to live in a rented house (0.65). Related to health, Class 1 was characterized by high GP healthcare expenditures (0.67), long-term illness (0.68) and negative perceptions of health (0.70). These women had a high probability of feeling lonely (0.87) and a moderate to high risk of depression or anxiety (0.87). Considering the vulnerabilities in different areas (including psychosocial, medical and socioeconomic risk factors), Class 1 was named ‘multidimensional vulnerability’. Class 2 (n = 485; 11.6%) was characterized by high healthcare expenditures. All women classified in this class had total healthcare expenditures in the highest quintile. Also, they frequently experienced high hospital care expenditures (0.69). Simultaneously, women in this class were likely to have protective factors including a healthy BMI (0.68), positive perception of health (0.87), high educational level (0.65), paid work (0.96), low probability of 2

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