In a study examining the impact of group versus individual prenatal care on birth weight and gestational age, researchers at Yale and Emory Universities found that group prenatal care was associated with significantly better weight gain for preterm infants.
Published in the November 2003 issue of Obstetrics and Gynecology, the study of 458 women showed that Centering Pregnancy, a new model of group prenatal care results in higher birth weight, especially for those who delivered preterm. Among those born pre-term, infants of group patients were almost one pound heavier than infants of individual-care patients. This difference is both statistically and clinically significant.
"These results could impact the design and delivery of future prenatal care services," said principal investigator Jeannette Ickovics, associate professor in the Department of Epidemiology and Public Health and in psychology at Yale.
Ickovics said she is aware of the challenges of changing health care systems to provide prenatal care in a group setting, but individual health care providers and their institutions often are seeking improved models for delivering quality, cost-effective prenatal care. "We think that the Centering Pregnancy program has the potential to improve health outcomes for all women and their children, but we are especially hopeful that group care could help reduce racial disparities in poor birth outcomes," she said.
Half of the women in the study entered group prenatal care; the other half received routine individual care. Women were matched by clinic, age, race and infant birth date. Study participants were predominantly black and Hispanic, of low socioeconomic status, and served by one of three public clinics in Atlanta, Georgia or New Haven, Connecticut.
The women attended the Centering Pregnancy Program, which alters routine prenatal care by providing care in groups. Women have their initial intake into their obstetric care in the usual manner. They are then invited to join eight to 12 other women due during the same month in a group setting where they receive all prenatal care as well as education and skills building on pregnancy, childbirth and early parenting.
Other authors on the study included Trace S. Kershaw, Heather Reynolds and Urania Magriples of Yale; Claire Westdahl, Emory University, Sharon Schindler Rising, Centering Pregnancy and Parenting Association and Carrie Klima, University of Illinois at Chicago.
Citation: Obstetrics and Gynecology Vol. 102 No. 5 Nov. 2003 p. 1051
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