Association of Gestational Weight Gain with Prenatal Care Model

Michelle Kominiarek*, Elizabeth Lucio Gray, Heidi Vyhmeister, William A Grobman, Melissa A Simon

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction: The objective of this study was to compare gestational weight gain (GWG) among women in group and traditional prenatal care. Methods: This is a retrospective cohort study of women who received prenatal care between 2011 and 2015 in a setting in which low-risk women had the option of group prenatal care. Women with height and initial and final weight were eligible. Women who chose group prenatal care were compared with women who chose traditional prenatal care and gave birth during the same study period. A propensity score analysis was used to create a matched control group from women who received traditional prenatal care. Bivariable comparisons of demographics, maternal characteristics, and GWG as a categorical variable (inadequate, adequate, or excessive per the 2009 Institute of Medicine guidelines) were performed with chi-square or Wilcoxon rank-sum tests. A logistic regression analysis was performed to estimate the association of group prenatal care with excessive GWG. Results: The final sample included 818 women who received either group or traditional prenatal care and were matched according to age, body mass index (BMI), nulliparity, and marital status. In the unadjusted analysis, women in group prenatal care had lower odds of excessive GWG (odds ratio [OR], 0.75; 95% CI, 0.57-0.99), but the statistical significance of this finding did not persist in the adjusted analysis (OR, 0.77; 95% CI, 0.45-1.30). When the analyses were limited to women who had at least 5 group or traditional prenatal care visits, there were no differences in excessive GWG in unadjusted (OR, 0.83; 95% CI, 0.59-1.16) or adjusted (OR, 0.97; 95% CI, 0.24-3.96) analyses. Discussion: In this propensity score matched cohort study of predominantly Hispanic women, there were no differences in excessive GWG between women in group compared with traditional prenatal care. Further study is indicated to determine the relationship between prenatal care model and GWG outcomes.

Original languageEnglish (US)
Pages (from-to)283-288
Number of pages6
JournalJournal of Midwifery and Women's Health
Volume63
Issue number3
DOIs
StatePublished - May 1 2018

Fingerprint

Prenatal Care
Weight Gain
Odds Ratio
Propensity Score
Nonparametric Statistics
Cohort Studies
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Marital Status
Parity
Hispanic Americans
Body Mass Index
Research Design
Retrospective Studies
Logistic Models
Regression Analysis
Mothers
Demography
Parturition

Keywords

  • CenteringPregnancy
  • antenatal care
  • group prenatal care
  • health disparities

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

Cite this

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title = "Association of Gestational Weight Gain with Prenatal Care Model",
abstract = "Introduction: The objective of this study was to compare gestational weight gain (GWG) among women in group and traditional prenatal care. Methods: This is a retrospective cohort study of women who received prenatal care between 2011 and 2015 in a setting in which low-risk women had the option of group prenatal care. Women with height and initial and final weight were eligible. Women who chose group prenatal care were compared with women who chose traditional prenatal care and gave birth during the same study period. A propensity score analysis was used to create a matched control group from women who received traditional prenatal care. Bivariable comparisons of demographics, maternal characteristics, and GWG as a categorical variable (inadequate, adequate, or excessive per the 2009 Institute of Medicine guidelines) were performed with chi-square or Wilcoxon rank-sum tests. A logistic regression analysis was performed to estimate the association of group prenatal care with excessive GWG. Results: The final sample included 818 women who received either group or traditional prenatal care and were matched according to age, body mass index (BMI), nulliparity, and marital status. In the unadjusted analysis, women in group prenatal care had lower odds of excessive GWG (odds ratio [OR], 0.75; 95{\%} CI, 0.57-0.99), but the statistical significance of this finding did not persist in the adjusted analysis (OR, 0.77; 95{\%} CI, 0.45-1.30). When the analyses were limited to women who had at least 5 group or traditional prenatal care visits, there were no differences in excessive GWG in unadjusted (OR, 0.83; 95{\%} CI, 0.59-1.16) or adjusted (OR, 0.97; 95{\%} CI, 0.24-3.96) analyses. Discussion: In this propensity score matched cohort study of predominantly Hispanic women, there were no differences in excessive GWG between women in group compared with traditional prenatal care. Further study is indicated to determine the relationship between prenatal care model and GWG outcomes.",
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Association of Gestational Weight Gain with Prenatal Care Model. / Kominiarek, Michelle; Gray, Elizabeth Lucio; Vyhmeister, Heidi; Grobman, William A; Simon, Melissa A.

In: Journal of Midwifery and Women's Health, Vol. 63, No. 3, 01.05.2018, p. 283-288.

Research output: Contribution to journalArticle

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AU - Kominiarek, Michelle

AU - Gray, Elizabeth Lucio

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