The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population

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• 作者：Amy H. Picklesimer ; MD ; MSPH^a ; Deborah Billings ; PhD^c ; Nathan Hale ; PhD^d ; Dawn Blackhurst ; DrPH^b ; Sarah Covington-Kolb ; MSPH ; MSW^a
• 关键词：CenteringPregnancy ; disparity ; prenatal care ; preterm birth
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2012
• 出版时间：May, 2012
• 年：2012
• 卷：206
• 期：5
• 页码：415.e1-415.e7
• 全文大小：371 K

文摘

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Objective

The purpose of this study was to evaluate the impact of group prenatal care on rates of preterm birth.

Study Design

We conducted a retrospective cohort study of 316 women in group prenatal care that was compared with 3767 women in traditional prenatal care. Women self-selected participation in group care.

Results

Risk factors for preterm birth were similar for group prenatal care vs traditional prenatal care: smoking (16.9 % vs 20 % ; P = .17), sexually transmitted diseases (15.8 % vs 13.7 % ; P = .29), and previous preterm birth (3.2 % vs 5.4 % ; P = .08). Preterm delivery (<37 weeks' gestation) was lower in group care than traditional care (7.9 % vs 12.7 % ; P = .01), as was delivery at <32 weeks' gestation (1.3 % vs 3.1 % ; P = .03). Adjusted odds ratio for preterm birth for participants in group care was 0.53 (95 % confidence interval, 0.34-0.81). The racial disparity in preterm birth for black women, relative to white and Hispanic women, was diminished for the women in group care.

Conclusion

Among low-risk women, participation in group care improves the rate of preterm birth compared with traditional care, especially among black women. Randomized studies are needed to eliminate selection bias.