39 Defining vulnerability subgroups among pregnant women Figure 2. Likelihood of adverse perinatal and maternal health outcomes and healthcare utilization for four classes, compared to the reference-category ‘healthy and socioeconomically stable’. The figure shows the OR and 95% CI (graphically and in text) DISCUSSION This study aimed to identify classes of vulnerability among pregnant women and to validate these classes by studying the association with adverse perinatal and maternal health outcomes and care utilization. The LCA procedure identified five classes with different combinations of risk and protective factors to vulnerability. Most women were classified into the ‘healthy and socioeconomically stable’ class with mainly protective factors. Women classified in the classes ‘high care utilization’, ‘socioeconomic vulnerability’ or ‘psychosocial vulnerability’ shared risk factors to vulnerability in one specific domain and protective factors in others. Women classified into the ‘multidimensional vulnerability’ class shared multiple risk factors in several domains (e.g., psychosocial, medical and socioeconomic) and were more likely to develop poor health outcomes such as premature birth, SGA, caesarean section and NICU admission. 2
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