Comparative effectiveness of group and individual prenatal care on gestational weight gain

Abstract

This study examined differences in gestational weight gain for women in CenteringPregnancy (CP) group prenatal care versus individually delivered prenatal care. We conducted a retrospective chart review and used propensity scores to form a matched sample of 393 women (76 % African-American, 13 % Latina, 11 % White; average age 22 years) receiving prenatal care at a community health center in the South. Women were matched on a wide range of demographic and medical background characteristics. Compared to the matched group of women receiving standard individual prenatal care, CP participants were less likely to have excessive gestational weight gain, regardless of their pre-pregnancy weight (b = -.99, 95 % CI [-1.92, -.06], RRR = .37). CP reduced the risk of excessive weight gain during pregnancy to 54 % of what it would have been in the standard model of prenatal care (NNT = 5). The beneficial effect of CP was largest for women who were overweight or obese prior to their pregnancy. Effects did not vary by gestational age at delivery. Post-hoc analyses provided no evidence of adverse effects on newborn birth weight outcomes. Group prenatal care had statistically and clinically significant beneficial effects on reducing excessive gestational weight gain relative to traditional individual prenatal care.

Figure 1

Predicted probabilities of type of gestational weight gain (GWG), by format of prenatal care. Note. GWG – gestational weight gain. Predicted probabilities estimated from multinomial logistic regression models shown in Model I, Table 3.

Figure 2

Predicted probabilities of type of gestational weight gain (GWG), by format of prenatal care and pre-pregnancy body mass index category. Note. GWG – gestational weight gain. Predicted probabilities estimated from multinomial logistic regression models shown in Model II, Table 3.