TY - JOUR
T1 - Association of Gestational Weight Gain with Prenatal Care Model
AU - Kominiarek, Michelle A.
AU - Gray, Elizabeth Lucio
AU - Vyhmeister, Heidi
AU - Grobman, William
AU - Simon, Melissa
N1 - Funding Information:
The authors acknowledge the support of the Erie Family Health Center Research Committee for the initiation and completion of this research study.
Publisher Copyright:
© 2018 by the American College of Nurse-Midwives
PY - 2018/5/1
Y1 - 2018/5/1
N2 - 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.
AB - 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.
KW - CenteringPregnancy
KW - antenatal care
KW - group prenatal care
KW - health disparities
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U2 - 10.1111/jmwh.12759
DO - 10.1111/jmwh.12759
M3 - Article
C2 - 29758122
AN - SCOPUS:85047651745
SN - 1526-9523
VL - 63
SP - 283
EP - 288
JO - Journal of Midwifery and Women's Health
JF - Journal of Midwifery and Women's Health
IS - 3
ER -