Gastrointestinal discomforts are a very common complaint in pregnancy. In fact, most pregnant women will experience at least one discomfort. This article focuses on 5 common conditions that occur in pregnancy: gastroesophageal reflux disease, diarrhea, constipation, hemorrhoids, and pica. While these conditions do occur in men and nonpregnant women, they occur more frequently in pregnancy because of the anatomic and physiologic changes associated with gestation. The type and severity of symptoms can vary from individual to individual, making treatment a challenge for healthcare providers, particularly when caring for pregnant women because the effects of medications and other treatments on the developing fetus are often not extensively studied. While these discomforts are rarely life-threatening, they can cause significant distress and impair quality of life. The goal of this article was to provide a summary of the anatomic and physiological changes during pregnancy that contribute to the increasing incidence of these discomforts and to provide information about each condition including prevalence, symptoms, and treatment modalities.

Background: Despite efforts to increase participation in prenatal care, outcomes for women and infants in the United States remain below global and national health targets. CenteringPregnancy, a model of group prenatal care, incorporates practices consistent with national and international guidelines while allowing for greater freedom in providing content tailored to the specific needs of women receiving care. Objective: To determine whether the CenteringPregnancy model improves maternal and neonatal health indicators such as prenatal care attendance, smoking cessation, weight gain during pregnancy, gestational age at delivery, mode of delivery, and initiation and continuation of breastfeeding. Methods: A retrospective study was conducted including all pregnant women participating in CenteringPregnancy at two prenatal clinic sites in southwest Michigan from January 2010 to April 2012 (n = 173). A comparison group of women receiving traditional care from certified nurse-midwives was created using propensity scores to match for age, race, and insurance status (n = 170). A chart review was performed to analyze maternal and neonatal health indicators including attendance at prenatal visits, gestational age at delivery, baseline maternal weight and weight gain during pregnancy, smoking cessation, infant birth weight, mode of delivery (vaginal birth vs. cesarean section), and rates of breastfeeding. Results: There were no significant differences in pre-pregnancy weight, amount of weight gained during pregnancy, prenatal care attendance, gestational age at delivery, mode of delivery or infant birth weight. The R. Zielinski et al. 498 CenteringPregnancy group had significantly higher rates of smoking cessation during pregnancy, as well as higher rates of breastfeeding initiation and continuation. Conclusions: This study provides support for the benefits of CenteringPregnancy in improving rates of smoking cessation during pregnancy which is important to both maternal and infant health. Additionally, in this population CenteringPregnancy resulted in improved rates of breastfeeding initiation and continuation, providing benefits to both infants and mothers.

No abstract