Abstract
Group prenatal care may be a promising alternative to traditional one-on-one care. However, research on its effects has produced inconsistent findings and raises questions about effectiveness across different patient populations. This pilot study evaluated the effects of March of Dimes Supportive Pregnancy Care (SPC) on maternal health and behavior across six diverse healthcare sites. Analyses of a propensity score-matched medical record dataset aggregated across sites (N = 1950) indicated significant unfavorable effects on gestational age at delivery (b = − 0.34, p < .05), birthweight (b = − 94.55, p < .05), and low birthweight (OR = 1.10, p < .05). However, these findings did not hold up to sensitivity analyses. Significant favorable aggregate effects were observed for postpartum visit attendance (OR = 1.68; 95% CI [1.12, 2.53]), breastfeeding at delivery (OR = 1.84; 95% CI [1.20, 2.83]), and breastfeeding at follow-up (OR = 3.82; 95% CI [1.46, 9.97]). These findings remained largely consistent across sensitivity analyses. In addition to these aggregate effects, significant site-level effects were observed, but only for two sites. Both were racially homogenous, serving White and African American patient populations, respectively. Future research should determine whether these effects can be generalized to women receiving care in racially heterogeneous settings or whether they are limited to White and African American women receiving care in racially homogenous settings. Efforts to roll out SPC should be accompanied by a continual accrual of research assessing the effects of this program on maternal and infant health across a range of geographic settings and patient profiles.
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Acknowledgments
The authors would like to thank Emily Tanner-Smith for her methodological guidance during the early phases of this study and Mark W. Lipsey for his comments on an earlier draft of this manuscript.
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This study was funded by March of Dimes.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Vanderbilt University Institutional Review Board, 170515) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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This study was funded by March of Dimes. The opinions expressed by the study authors do not necessarily reflect the opinions of March of Dimes or of March of Dimes funders.
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Kettrey, H.H., Steinka-Fry, K.T. Effects of March of Dimes Supportive Pregnancy Care on Maternal and Infant Health Across Diverse Patient Populations: a Quasi-Experimental Multi-Site Pilot Study. Prev Sci 21, 293–307 (2020). https://doi.org/10.1007/s11121-019-01083-5
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DOI: https://doi.org/10.1007/s11121-019-01083-5