Social determinants of vulnerability in the population of reproductive age: A systematic review

van der Meer et al. BMC Public Health (2022) 22:1252

https://doi.org/10.1186/s12889-022-13651-6

RESEARCH

Social determinants of vulnerability

in the population of reproductive age:

a systematic review

Lindsey van der Meer1*, Lisa S. Barsties1,2, Leonie A. Daalderop1,2, Adja J. M. Waelput1

, Eric A. P. Steegers1 and

Loes C. M. Bertens1

Abstract

Background: The health of an (unborn) child is largely determined by the health and social determinants of its

parents. The extent to which social determinants of parents or prospective parents afect their own health depends

partly on their coping or resilience abilities. Inadequate abilities allow negative efects of unfavourable social deter￾minants to prevail, rendering them vulnerable to adverse health outcomes. Addressing these determinants in the

reproductive-aged population is therefore a key approach in improving the health of the future generation. This

systematic review aims to synthesise evidence on social determinants of vulnerability, i.e., inadequate coping or low

resilience, in the general population of reproductive age.

Methods: The databases EMBASE, Medline, PsycINFO, CINAHL, Google Scholar, Web of Science, and Cochrane Library,

were systematically searched from database inception to December 2th 2021.

Observational studies examining social determinants and demographics in relation to vulnerability among the

general population of reproductive age (men and women aged 18-40 years), conducted in a high-income country in

Europe or North America, Australia or New Zealand were eligible for inclusion. Relevant data was extracted from each

included article and fndings were presented in a narrative and tabulated manner.

Results: We identifed 40,028 unique articles, of which 78 were full text reviewed. Twenty-fve studies were included,

of which 21 had a cross-sectional study design (84%). Coping was the most frequently assessed outcome measure

(n =17, 68%). Thirty social determinants were identifed. Overall, a younger age, lower socioeconomic attainment,

lack of connection with the social environment, and adverse life events were associated with inadequate coping or

low resilience.

Conclusions: This review shows that certain social determinants are associated with vulnerability in reproductive￾aged individuals. Knowing which factors make people more or less vulnerable carries health-related implications.

More high-quality research is needed to obtain substantial evidence on the strength of the efect of these social

conditions in this stage of life.

Keywords: Social determinants, Epidemiology, Population health, Vulnerable populations, Preconception care

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Background

Tere exists a social gradient in health that is visible

throughout the entire life course. Socially disadvantaged

individuals are at higher risk of adverse health outcomes

compared to those who are socially privileged [1, 2].

Open Access

*Correspondence: [email protected]

1

Department of Obstetrics and Gynaecology, Erasmus MC, University Medical

Center Rotterdam, PO Box 2040, Rotterdam 3000 CA, The Netherlands

Full list of author information is available at the end of the article