Mohabier Kajal S C, Burgos-Ochoa Lizbeth, de Graaf Johanna P, Steegers Eric A P, Bertens Loes C M
Department of Obstetrics and Gynaecology, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
Eur J Public Health. 2025 Jun 1;35(3):521-527. doi: 10.1093/eurpub/ckaf062.
Pregnancy can be considered a window of opportunity to help pregnant women optimize the circumstances they live in. Within the Mothers of Rotterdam study, pregnant women in highly vulnerable circumstances received standard social care or targeted social care to improve their circumstances. Women in this study had many combinations of non-medical risk factors contributing to their vulnerable circumstances. Here, the aim is to study the association between different combinations of non-medical risk factors and duration of care. Existing non-medical risk factors, assessed with a vulnerability checklist, were clustered using Latent Class Analysis (LCA). Linear regression was used to examine the relationship with duration of social care. The model was adjusted for maternal age, deprived neighbourhood, and type of social care. Four vulnerability classes were identified among 840 women and were labelled complex (9%), educational (24%), social network (12%), and financial vulnerability (55%). In the unadjusted model, all three classes showed a significant longer duration of social care compared to the financial vulnerability class. After adjustment, only the longer duration of care of the social network vulnerability class remained statistically significant. The four identified vulnerability classes illustrate that even within a group of women in highly vulnerable circumstances, subgroups of vulnerability exist. The vulnerability classes were identifiable through different combinations of non-medical risk factors and are all, associated with different durations of social care. These findings help to understand, and plan for, the requirements of social care for women in highly vulnerable circumstances.
怀孕可被视为一个帮助孕妇优化其生活环境的契机。在鹿特丹母亲研究中，处于高度脆弱环境的孕妇接受了标准社会护理或针对性社会护理以改善她们的处境。该研究中的女性有多种非医疗风险因素组合导致她们处于脆弱环境。在此，目的是研究不同非医疗风险因素组合与护理时长之间的关联。使用潜在类别分析（LCA）对通过脆弱性清单评估的现有非医疗风险因素进行聚类。采用线性回归来检验与社会护理时长的关系。该模型针对产妇年龄、贫困社区和社会护理类型进行了调整。在840名女性中识别出了四类脆弱性，并分别标记为复杂型（9%）、教育型（24%）、社交网络型（12%）和经济脆弱型（55%）。在未调整的模型中，与经济脆弱型类别相比，所有其他三类的社会护理时长均显著更长。调整后，只有社交网络脆弱型类别的护理时长更长在统计学上仍具有显著性。识别出的这四类脆弱性表明，即使在处于高度脆弱环境的女性群体中，也存在脆弱性子群体。这些脆弱性类别可通过不同的非医疗风险因素组合来识别，并且都与不同的社会护理时长相关。这些发现有助于理解并规划处于高度脆弱环境的女性的社会护理需求。
