43 Defining vulnerability subgroups among pregnant women Key points • Previous evidence supports the influence of social factors on maternal and perinatal health, but few studies consider the combination of different social risk and protective factors to vulnerability. • Pre-pregnancy data of 4172 women on a wide range of social risk and protective factors to vulnerability were used to identify latent vulnerability classes. • Five classes could be distinguished: multidimensional vulnerability, high care utilization, socioeconomic vulnerability, psychosocial vulnerability and a healthy and socioeconomically stable-class. • Multidimensional vulnerability, characterized by experiencing risk factors in different domains and few protective factors, was associated with adverse outcomes for mother and child, while experiencing risk factors solely in one domain was not necessarily associated with adverse outcomes. • Public health programmes should start preconceptionally, include both medical and social care and support, and be attentive to systemic causes of vulnerability 2
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