Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers

J.R. Ickovics, V. Earnshaw, J.B. Lewis, T.S. Kershaw, U. Magriples, E. Stasko, S.S. Rising, A. Cassells, S. Cunningham, P. Bernstein and J.N. Tobin

American Journal of Public Health, 2016, vol. 106, issue 2, 359-365

Abstract: Objectives. We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes. Methods. We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008-2012).Weanalyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys. Results. In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (> 10th percentile; 11.0% vs 15.8%; odds ratio = 0.66; 95% confidence interval = 0.44, 0.99). In as-treated analyses, women with more group visits had better outcomes, including small for gestational age, gestational age, birth weight, days in neonatal intensive care unit, rapid repeat pregnancy, condom use, and unprotected sex (P = .030 to > .001). There were no associated risks. Conclusions. CenteringPregnancy Plus group prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change.

Keywords: adolescent; birth weight; clinical trial; controlled study; female; gestational age; human; infant; intention to treat analysis; multicenter study; New York; patient attitude; pregnancy; pregnancy outcome; prenatal care; procedures; randomized controlled trial; social class; young adult, Adolescent; Birth Weight; Female; Gestational Age; Humans; Infant; Intention to Treat Analysis; New York City; Patient Acceptance of Health Care; Pregnancy; Pregnancy Outcome; Prenatal Care; Social Class; Young Adult (search for similar items in EconPapers)
Date: 2016
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Citations: View citations in EconPapers (4)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302960_9

DOI: 10.2105/AJPH.2015.302960

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