49 Defining vulnerability subgroups among pregnant women Variable Definition Categories Data source* Physical activity Compliance with guidelines for physical activity (>150 minutes of moderate to vigorous intensive activities every week, as well as muscle and bone strengthening activities) as measured by the SQUASH-questionnaire10 Less than recommended; as recommended or more PHM-2016 Body Mass Index (BMI) BMI based on height and weight. According to the International Obesity Task Force, BMI <15 is underweight, BMI 18,5 – 25 is normal weight and BMI ≥25 overweight11. Underweight and overweight are categorized into ‘unhealthy BMI’. Normal weight is categorized into ‘healthy BMI’ Unhealthy BMI; healthy BMI PHM-2016 Household characteristics Type of household Type of household was categorized based on registrations of persons living at the same home address. Women without a registered partner were classified as a one-person household (without children) or a one-parent household (with children). All other types were categorized into ‘other’ One-person/ parent household; other SSD Marital status Marital status of the woman Unmarried; married SSD Dissolution of marriage*** Having been divorced [2012-2016] Yes; no SSD Household size Number of persons registered at the same home address ≥6 persons; <6 persons SSD Youth support uptake*** Previously received youth support for children within the family [2015-2016] Yes; no SSD Self-reported health Perceived health status Based on the question: ‘how is your health in general?’ and categorized into negative (very bad or bad) and positive (very good, good or moderate) Negative; positive PHM-2016 Long-term illness Based on the question: ‘do you have one or more long-term (≥ 6 months) illnesses or disorders?’ Yes; no PHM-2016 Restricted by health Based on the question ‘to what extent have you been limited in activities due to health for the last 6 months or longer?’ into yes (severely limited or limited) and no (not limited) Yes; no PHM-2016 Healthcare expenditures and utilization Overall healthcare expenditures Total healthcare expenditures in 2016 subdivided into quintiles and divided into high (quintile 5) and low-average (quintile 1 to 4). In case a woman was pregnant in 2016, total healthcare expenditures of the previous year (2015 or 2014) were included High; lowaverage SSD (Vektis) General practitioners’ (GP) expenditures GP expenditures in 2016 subdivided into quintiles and divided into high (quintile 5) and low-average (quintile 1 to 4) High; lowaverage SSD (Vektis) 10 Gezondheidsraad [Dutch Health Council]. Beweegrichtlijnen 2017 [exercise guidelines 2017]. Den Haag: Gezondheidsraad, 2017. 11 Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240-3. 2
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