Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics.
OBJECTIVE
To examine the impact of group versus individual prenatal care on birth weight and gestational age.


METHODS
This prospective, matched cohort study included pregnant women (N = 458) entering prenatal care at 24 or less weeks' gestation; one half received group prenatal care with women of the same gestational age. Women were matched by clinic, age, race, parity, and infant birth date. Women were predominantly black and Hispanic of low socioeconomic status, served by one of three public clinics in Atlanta, Georgia or New Haven, Connecticut.


RESULTS
Birth weight was greater for infants of women in group versus individual prenatal care (P < .01). Among those born preterm, infants of group patients were significantly larger than infants of individual-care patients (mean, 2398 versus 1990 g, P < .05). Although not statistically significant, infants of group patients were less likely than those of individual-care patients to be low birth weight (less than 2500 g; 16 versus 23 infants); very low birth weight (less than 1500 g; three versus six infants); early preterm (less than 33 weeks; two versus seven infants); or to experience neonatal loss (none versus three infants). There were no differences in number of prenatal visits or other risk characteristics (patient age, race, prior preterm birth).


CONCLUSIONS
Group prenatal care results in higher birth weight, especially for infants delivered preterm. Group prenatal care provides a structural innovation, permitting more time for provider-patient interaction and therefore the opportunity to address clinical as well as psychological, social, and behavioral factors to promote healthy pregnancy. Results have implications for design of sustainable prenatal services that might contribute to reduction of racial disparities in adverse perinatal outcomes.
Ickovics
Jeannette R
JR
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA. jeannette.ickovics@Yale.edu
Kershaw
Trace S
TS
Westdahl
Claire
C
Rising
Sharon Schindler
SS
Klima
Carrie
C
Reynolds
Heather
H
Magriples
Urania
U
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D001724:Birth Weight; D015331:Cohort Studies; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D006126:Group Processes; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D011295:Prenatal Care / Q000379:methods* / Q000458:organization & administration / Q000706:statistics & numerical data; D011446:Prospective Studies