The Effect of Centering Pregnancy versus Traditional Prenatal Care Models on Improved Adolescent Health Behaviors in the Perinatal Period

Objective To estimate the effect of group prenatal care on perinatal outcomes compared with traditional prenatal care. Data Sources We searched MEDLINE through PubMed, EMBASE, Scopus, Cumulative Index of Nursing and Allied Health literature [CINAHL], the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects [DARE], the Cochrane Central Register of Controlled Trials [CENTRAL]) and clinicaltrials.gov. Methods of Study Selection We searched electronic databases for randomized controlled trials (RCT) and observational studies comparing group care with traditional prenatal care. The primary outcome was preterm birth. Secondary outcomes were low birthweight (LBW), neonatal intensive care unit (NICU) admission, and breastfeeding initiation. Heterogeneity was assessed using the Q test and I2 statistic. Pooled relative risks (RRs) and weighted mean differences were calculated using random-effects models. Tabulations, Integration, and Results Four RCTs and ten observational studies met inclusion criteria. The rate of preterm birth was not significantly different with group care compared with traditional care (11 studies: pooled rates 7.9% vs. 9.3%, pooled RR 0.87; 95% CI 0.70–1.09). Group care was associated with a decreased rate of LBW overall (9 studies: pooled rate 7.5% group care vs. 9.5% traditional care; pooled RR 0.81; 95% CI 0.69–0.96), but not among RCTs (4 studies: 7.9% group care vs. 8.7% traditional care, pooled RR 0.92; 95% CI 0.73–1.16). There were no significant differences in NICU admission or breastfeeding initiation. Conclusion Available data suggest that women who participate in group care have similar rates of preterm birth, NICU admission, and breastfeeding.

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“…It is unclear whether women with prior preterm birth were excluded from the remaining studies. (11, 19–21, 25, 26)…”

Section: Resultsmentioning

confidence: 99%

Group Prenatal Care Compared With Traditional Prenatal Care

Carter

Temming

Akin

et al. 2016

Obstetrics &Amp; Gynecology

148

122

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“…The typical CenteringPregnancy model, in which mothers attended group sessions for their prenatal care within a hospital, was associated with reduced preterm births, improved birth weight, and increased maternal weight gain in pregnancy, as well as adequacy of prenatal care and maternal satisfaction with care . An association between CenteringPregnancy and postpartum family planning has also been documented, as well as a positive correlation between CenteringPregnancy and adolescent health behavior in the perinatal period . However, there have been concerns about a lower perception of the value of prenatal care as well as a low tendency to engage in some health‐seeking behaviors among CenteringPregnancy mothers …”

Section: Introductionmentioning

confidence: 99%

“…5 An association between CenteringPregnancy and postpartum family planning has also been documented, 6 as well as a positive correlation between CenteringPregnancy and adolescent health behavior in the perinatal period. 7 However, there have been concerns about a lower perception of the value of prenatal care as well as a low tendency to engage in some health-seeking behaviors among CenteringPregnancy mothers. 8 Group prenatal care has been gaining worldwide attention as an alternative to traditional one-to-one care.…”

mentioning

confidence: 99%

Women's experience with group prenatal care in a rural community in northern Nigeria

Adaji

Jimoh

Bawa

et al. 2019

Intl J Gynecology & Obste

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Objective To assess women's experience of group prenatal care in a rural Nigerian community. Methods In an observational study, consenting pregnant women were enrolled in a group prenatal care program based on the CenteringPregnancy model from July 1, 2010, to June 30, 2011, in Tsibiri, Nigeria. Women were interviewed before joining the group and postnatally. A predesigned pro forma was used to assess group behavior during sessions. Descriptive and inferential statistics were applied to data. Results In total, 161 women enrolled, and 54 of 72 scheduled prenatal sessions took place. The average number of visits was three per woman, with good group interaction and cohesion. Mothers who could mention at least five out of eight danger signs of pregnancy increased from 1.4% (2) to 13.3% (14) (P<0.001, 95% CI 4.28–19.52), while mean knowledge score for danger signs increased from 31% to 47.8% (P<0.001, 95% CI 0.86–2.16). Commitment to birth preparedness plans was impressive. The mothers enjoyed the group sessions and shared the lessons they learned with others. Conclusion Group prenatal care was feasible and acceptable to women in the present study setting. Comparative trials would be helpful to demonstrate the benefits of the tested model in low‐income settings.

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“…For example, a woman who is struggling with her weight gain might receive practical advice from her peer group and likely gain tremendous encouragement when the goals are met. In a study comparing GPC to traditional care, adolescent women in GPC were more likely to achieve gestational weight guidelines and breastfeed exclusively, as well as experience lower rates of postpartum depression [23]. GPC was also shown to increase utilization of postpartum family-planning services [24], thus providing positive lifestyle support throughout the reproductive period and increasing the likelihood of pregnancy intentionality and healthy birth spacing.…”

Section: Encourages Behavioral Changementioning

confidence: 99%