Background
Materials and methods
Study population
Collected data
Statistical analysis
Results
Vulnerability | Category | N (%) | Weights of category1 | ||
---|---|---|---|---|---|
Factorial axis 1 | Factorial axis 2 | Factorial axis 3 | |||
Recent immigration | Immigration < 12 month | 353 (4.6) |
2.81
| -0.55 |
-1.7
|
No recent immigration | -0.14 | 0.03 | 0.08 | ||
Household income | Not work-related household income | 2521 (33.0) |
1
|
-0.46
| 0.17 |
Work-related household income | -0.49 | 0.23 | -0.08 | ||
Social insurance | No permanent health care insurance | 2037 (26.7) |
1.07
|
-0.61
| -0.11 |
Being insured | -0.39 | 0.22 | 0.04 | ||
Housing condition | Poor or insecure housing condition | 1128 (14.8) |
1.43
| -0.36 |
0.88
|
Living in personal housing | -0.25 | 0.06 | -0.15 | ||
History of violence | Interpersonal violence during pregnancy | 546 (7.1) |
1.89
|
1.23
|
-1.39
|
No history of violence during pregnancy | -0.15 | -0.09 | 0.11 | ||
Social isolation | Not living with a partner | 1279 (16.7) |
1.13
| 0.33 |
0.8
|
Living with a partner | -0.23 | -0.07 | -0.16 | ||
Psychological distress2 | Psychological distress during pregnancy | 1047 (13.7) |
1.08
|
1.56
| -0.23 |
No psychological distress during pregnancy | -0.17 | -0.25 | 0.04 | ||
Linguistic barrier | Linguistic barrier during pregnancy | 492 (6.4) | 1.02 |
-1.62
|
-0.93
|
No linguistic barrier during pregnancy | -0.07 | 0.11 | 0.06 | ||
Severe dependency | Minor or with handicap patient | 230 (3.0) | 1.43 | 0.86 |
3.56
|
Major patient without handicap | -0.04 | -0.03 | -0.11 | ||
Addiction3 | Addiction during pregnancy | 1315 (17.2) | 0.18 |
0.87
| 0.49 |
No history of addiction during pregnancy | -0.04 | -0.18 | -0.1 | ||
Psychiatric disease4 | Psychiatric disease during pregnancy | 236 (3.1) | 1.73 |
2.81
|
-1.39
|
No psychiatric disease during pregnancy | -0.06 | -0.09 | 0.04 |
Profile 1 | Profile 2 | Profile 3 | Profile 4 | Profile 5 | p | |
---|---|---|---|---|---|---|
N = 4651 | N = 773 | N = 1597 | N = 329 | N = 293 | ||
Maternal Characteristics
| ||||||
Maternal age (median [IQR]) | 31.49 [28.03, 35.10] | 32.27 [28.05, 36.22] | 29.70 [25.47, 34.33] | 26.98 [20.99, 32.58] | 29.76 [25.35, 34.62] | < 0.001 |
BMI (median [IQR]) | 24.98 [22.27, 28.70] | 25.16 [22.59, 29.34] | 25.24 [22.58, 28.65] | 24.44 [22.22, 28.16] | 25.08 [23.63, 28.71] | 0.257 |
Parity (median [IQR]) | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | < 0.001 |
Maternal origin n (%) | < 0.001 | |||||
Sub-Saharan Africa | 1617 ( 34.8) | 255 ( 33.0) | 626 ( 39.2) | 150 ( 45.6) | 167 ( 57.0) | |
Asia | 572 ( 12.3) | 111 ( 14.4) | 187 ( 11.7) | 39 ( 11.9) | 23 ( 7.8) | |
Caucasian | 2462 ( 52.9) | 407 ( 52.7) | 784 ( 49.1) | 140 ( 42.6) | 103 ( 35.2) | |
High medical risk level before pregnancy1 n (%) | 387 ( 8.3) | 196 ( 25.4) | 139 ( 8.7) | 41 ( 12.5) | 84 ( 28.7) | < 0.001 |
High obstetrical risk level before pregnancy2 n (%) | 1180 ( 25.4) | 269 ( 34.8) | 412 ( 25.8) | 79 ( 24.0) | 74 ( 25.3) | < 0.001 |
Inadequate PCU3 n (%) | 387 ( 8.3) | 85 ( 11.0) | 300 ( 18.8) | 76 ( 23.1) | 75 ( 25.6) | < 0.001 |
Unwanted pregnancy n (%) | 14 ( 0.3) | 15 ( 2.1) | 5 ( 0.3) | 13 ( 4.0) | 9 ( 3.1) | < 0.001 |
Social vulnerabilities
| ||||||
Immigration < 12 month n (%) | 0 ( 0.0) | 0 ( 0.0) | 145 ( 9.1) | 6 ( 1.8) | 202 ( 68.9) | < 0.001 |
Not work-related household income n (%) | 452 ( 9.7) | 148 ( 19.1) | 1409 ( 88.2) | 231 ( 70.2) | 281 ( 95.9) | < 0.001 |
No permanent health care insurance n (%) | 343 ( 7.4) | 84 ( 10.9) | 1183 ( 74.1) | 154 ( 46.8) | 273 ( 93.2) | < 0.001 |
Poor or insecure housing condition n (%) | 57 ( 1.2) | 51 ( 6.6) | 703 ( 44.0) | 187 ( 56.8) | 130 ( 44.4) | < 0.001 |
Not living with a partner n (%) | 308 ( 6.6) | 137 ( 17.7) | 460 ( 28.8) | 205 ( 62.3) | 169 ( 57.7) | < 0.001 |
Psychological distress4 n (%) | 7 ( 0.2) | 606 ( 78.4) | 60 ( 3.8) | 154 ( 46.8) | 220 ( 75.1) | < 0.001 |
Psychiatric disease5 n (%) | 0 ( 0.0) | 138 ( 17.9) | 0 ( 0.0) | 11 ( 3.3) | 87 ( 29.7) | < 0.001 |
Addiction6 n (%) | 712 ( 15.3) | 233 ( 30.1) | 173 ( 10.8) | 144 ( 43.8) | 53 ( 18.1) | < 0.001 |
Severe dependency n (%) | 0 ( 0.0) | 3 ( 0.4) | 4 ( 0.3) | 219 ( 66.6) | 4 ( 1.4) | < 0.001 |
Linguistic barrier n (%) | 94 ( 2.0) | 4 ( 0.5) | 328 ( 20.5) | 9 ( 2.7) | 57 ( 19.5) | < 0.001 |
History of violence n (%) | 0 ( 0.0) | 230 ( 29.8) | 55 ( 3.4) | 26 ( 7.9) | 235 ( 80.2) | < 0.001 |
Pregnancy outcomes
| ||||||
Pregnancy complications7 n (%) | 2686 ( 57.8) | 548 ( 70.9) | 1055 ( 66.1) | 207 ( 62.9) | 197 ( 67.2) | < 0.001 |
Premature birth (< 37 weeks) n (%) | 317 ( 6.8) | 216 ( 27.9) | 146 ( 9.1) | 48 ( 14.6) | 33 ( 11.3) | < 0.001 |
SGA8 n (%) | 838 ( 18.0) | 192 ( 24.8) | 322 ( 20.2) | 81 ( 24.6) | 77 ( 26.3) | < 0.001 |
Pregnancy outcome n (%) | ||||||
Neonatal death | 0 ( 0.0) | 0 ( 0.0) | 1 ( 0.1) | 0 ( 0.0) | 1 ( 0.3) | NA |
Late miscarriage | 23 ( 0.5) | 26 ( 3.4) | 7 ( 0.4) | 3 ( 0.9) | 0 ( 0.0) | < 0.001 |
Medical abortion | 10 ( 0.2) | 20 ( 2.6) | 6 ( 0.4) | 3 ( 0.9) | 2 ( 0.7) | < 0.001 |
Stillbirth | 18 ( 0.4) | 33 ( 4.3) | 12 ( 0.8) | 5 ( 1.5) | 1 ( 0.3) | < 0.001 |
Inadequate prenatal care use
| ||
OR
|
aOR
| |
Profile 1 | ref | ref |
Profile 2 | 1.36 [1.06–1.74]* | 1.37 [1.06–1.76]* |
Profile 3 | 2.55 [2.16–3.00]*** | 2.36 [2.00–2.78]*** |
Profile 4 | 3.31 [2.50–4.35]*** | 2.94 [2.20–3.89]*** |
Profile 5 | 3.79 [2.84–5.01]*** | 3.14 [2.33–4.18]*** |
Premature birth (< 37 weeks)
| ||
OR
|
aOR
| |
Profile 1 | ref | ref |
Profile 2 | 5.30 [4.36–6.43]*** | 4.64 [3.80–5.66]*** |
Profile 3 | 1.38 [1.12–1.69]** | 1.44 [1.17–1.77]** |
Profile 4 | 2.34 [1.67–3.21]*** | 2.54 [1.80–3.52]*** |
Profile 5 | 1.74 [1.17–2.50]** | 1.67 [1.12–2.44]** |
Small for gestational age
[[1]]
| ||
OR
|
aOR
| |
Profile 1 | ref | ref |
Profile 2 | 1.50 [1.25–1.80]*** | 1.47 [1.22–1.76]*** |
Profile 3 | 1.15 [0.99–1.33] | 1.17 [1.01–1.35]* |
Profile 4 | 1.49 [1.14–1.92]** | 1.44 [1.10–1.88]** |
Profile 5 | 1.62 [1.23–2.12]*** | 1.60 [1.20–2.10]** |
Stillbirth
| ||
IRR
|
aIRR
| |
Profile 1 | ref | ref |
Profile 2 | 11.0 [6.29–19.99]*** | 10.9 [6.11–19.99]*** |
Profile 3 | 1.94 [0.91–3.99] | 1.88 [0.88–3.89] |
Profile 4 | 3.93 [1.30–9.84]** | 3.98 [1.30–10.12]** |
Profile 5 | 0.88 [0.05–4.27] | 0.82 [0.05–4.03] |
Late miscarriage
| ||
IRR
|
aIRR
| |
Profile 1 | ref | ref |
Profile 2 | 6.80 [3.88–12.00]*** | 7.39 [4.17–13.19]*** |
Profile 3 | 0.89 [0.35–1.96] | 0.90 [0.36–2.01] |
Profile 4 | 1.84 [0.44–5.30] | 1.91 [0.45–5.62] |
Profile 5 | 0.00 [0.00–0.00] | 0.00 [0.00–0.00] |
Medical abortion
| ||
IRR
|
aIRR
| |
Profile 1 | ref | ref |
Profile 2 | 12.03 [5.76–26.81]*** | 12.65 [5.96–28.49]*** |
Profile 3 | 1.75 [0.59–4.71] | 1.99 [0.68–5.38] |
Profile 4 | 4.24 [1.05–13.86]* | 5.78 [1.28–19.19]** |
Profile 5 | 3.17 [0.49–12.04] | 3.89 [0.59–15.10] |