Abstract
Purpose
Prenatal care is important for positive outcomes for both mother and infant. The traditional one-on-one method remains the most common. This study aimed to compare perinatal outcomes of patients attending group prenatal care with traditional prenatal care. Most previously published comparisons did not match for parity, a key predictor of perinatal outcome.
Description
We collected perinatal outcome data for 137 group prenatal care patients and 137 traditional prenatal care patients, matched for contemporaneous delivery and parity, who delivered at our small rural hospital during 2015–2016. We included key public health variables, including the initiation of breastfeeding, and smoking at the time of delivery.
Assessment
There was no difference between the two groups for maternal age or infant ethnicity, induced or augmented labor, preterm deliveries, APGAR scores less than 7, low birth weight, NICU admissions, or cesarean deliveries. Group care patients had more prenatal visits and were more likely to initiate breastfeeding and were less likely to report smoking at the time of delivery.
Conclusion
In our rural population matched for contemporaneous delivery and parity, we found no difference in traditional perinatal outcome measures and that group care was positively associated with the key public health variables of not smoking and initiating breastfeeding. If future studies in other populations have similar findings, it may be wise to provide group care more widely to rural populations.
Significance
We provide a comprehensive table comparing previous studies of group care with a focus on differences in the populations studied. Ours is the first to provide perinatal outcomes from a rural population in the US and only the second to match for parity, a key predictor. Our groups were smaller than previous reports, but our complete matching on parity and contemporaneous delivery of the control group are strengths. We found no difference in traditional perinatal outcome, but group care patients reported higher rates of breastfeeding and not smoking, a difference only found in two previous urban-based reports.
This is a preview of subscription content, log in via an institution to check access.
Data Availability
The data that support the findings of this study are available from the corresponding author, WJC, upon reasonable request.
Code Availability
Not applicable.
References
ACOG Committee on Obstetric Practice. (2018). ACOG committee opinion no. 731: Group prenatal care. Obstetrics & Gynecology, 131(3), e104–e108. https://doi.org/10.1097/AOG.0000000000002529
Alexander, G. R., & Korenbrot, C. C. (1995). The role of prenatal care in preventing low birth weight. Future of Children, 5(1), 103–120.
Benediktsson, I., McDonald, S. W., Vekved, M., McNeil, D. A., Dolan, S. M., & Tough, S. C. (2013). Comparing centering pregnancy(R) to standard prenatal care plus prenatal education. BMC Pregnancy and Childbirth. https://doi.org/10.1186/1471-2393-13-s1-s5
Carter, E. B., Barbier, K., Sarabia, R., Macones, G. A., Cahill, A. G., & Tuuli, M. G. (2016a). Group versus traditional prenatal care: A retrospective cohort study. American Journal of Obstetrics and Gynecology, 214(1), S161.
Carter, E. B., Temming, L. A., Akin, J., Fowler, S., Macones, G. A., Colditz, G. A., & Tuuli, M. G. (2016b). Group prenatal care compared with traditional prenatal care: A systematic review and meta-analysis. Obstetrics & Gynecology, 128(3), 551–561. https://doi.org/10.1097/aog.0000000000001560
Chae, S. Y., Chae, M. H., Kandula, S., & Winter, R. O. (2017). Promoting improved social support and quality of life with the centering Pregnancy® group model of prenatal care. Archives of Women’s Mental Health, 20(1), 209–220. https://doi.org/10.1007/s00737-016-0698-1.
Cunningham, S. D., Lewis, J. B., Shebl, F. M., Boyd, L. M., Robinson, M. A., Grilo, S. A., Lewis, S. M., Pruett, A. L., & Ickovics, J. R. (2018). Group prenatal care reduces risk of preterm birth and low birth weight: a matched cohort study. Journal of Women’s Health, 28(1), 17–22. https://doi.org/10.1089/jwh.2017.6817.
Gennaro, S., Melnyk, B. M., O’Connor, C., Gibeau, A. M., & Nadel, E. (2016). Improving prenatal care for minority women. MCN The American Journal of Maternal Child Nursing, 41(3), 147–153. https://doi.org/10.1097/nmc.0000000000000227.
Ickovics, J. R., Earnshaw, V., Lewis, J. B., Kershaw, T. S., Magriples, U., Stasko, Rising, S. S., Cassells, A., Cunningham, S., Bernstein, P., & Tobin, J. N. (2016). Cluster randomized controlled trial of group prenatal care: perinatal outcomes among adolescents in New York City health centers. American Journal of Public Health, 106(2), 359–365. https://doi.org/10.2105/ajph.2015.302960.
Ickovics, J. R., Kershaw, T. S., Westdahl, C., Magriples, R., Massey, Z., Reynolds, H., & Rising, S. S. (2007). Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstetrics and Gynecology, 110(2 Pt 1), 330–339. https://doi.org/10.1097/01.aog.0000275284.24298.23.
Ickovics, J. R., Kershaw, T. S., Westdahl, C., Rising, S. S., Klima, C., Reynolds, H., & Magriples, R. (2003). Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics. Obstetrics & Gynecology, 102(5, Pt1), 1051–1057. https://doi.org/10.1016/s0029-7844(03)00765-8.
Kennedy, H. P., Paden, R., Hill, S., Jolivet, R. R., Cooper, B. A., & Rising, S. S. (2011). A randomized clinical trial of group prenatal care in two military settings. Military Medicine, 176(10), 1169–1177. https://doi.org/10.7205/milmed-d-10-00394.
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Centers for Disease Control and Prevention (US). https://www.ncbi.nlm.nih.gov/books/NBK99237/. Accessed 29 Jan 2020.
Picklesimer, A. H., Billings, D., Hale, N., Blackhurst, D., & Convington-Kolb, D. (2012). The effect of centering pregnancy group prenatal care on preterm birth in a low-income population. American Journal of Obstetrics and Gynecology, 206(5), 415e1–e7. https://doi.org/10.1016/j.ajog.2012.01.040.
Pineles, B. L., Hsu, S., Park, E., & Smaet, J. M. (2016). Systematic review and meta-analyses of perinatal death and maternal exposure to tobacco smoke during pregnancy. American Journal of Epidemiology, 184(2), 87–97. https://doi.org/10.1093/aje/kwv301.
Rising, S. S. (1998). Centering pregnancy: an interdisciplinary model of empowerment. Journal of Nurse-Midwifery, 43(1), 46–54. https://doi.org/10.1016/S0091-2182(97)00117-1.
Zorrilla, C. D., Sánchez, I., Mosquera, A. M., Sierra, D., Pérez, L. A. L., Rabionet, S., & Rivera-Viñas, J. (2017). Improved infant outcomes with group prenatal care in Puerto Rico.Source Journal of Obstetrics and Gynaecology. 1(1). http://sourcejournals.com/journal/source-journal-of-obstetrics-and-gynaecology-sjog/current-issue. Accessed 29 Jan 2020.
Acknowledgements
The authors would like to thank Nita Nair, a summer research assistant, for her attention to detail in data entry and Steve Fricker for assistance with data management and analysis. The authors declare there were no outside funds supporting this study.
Funding
None.
Author information
Authors and Affiliations
Contributions
All authors involved in all stages of the study and manuscript preparation.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
The Institutional Review Board for Baptist Health Madisonville determined this study was exempt.
Consent to Participate
Not applicable.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jones, T.H., Crump, W.J., Foster, S.M. et al. Group Prenatal Care vs. Traditional Prenatal Care: A Parity-Matched Comparison of Perinatal Outcomes in a Rural Community. Matern Child Health J 27, 575–581 (2023). https://doi.org/10.1007/s10995-023-03600-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-023-03600-z