Peabody Research Institute, Vanderbilt University, 230 Appleton Place, Box 0181 GPC, Nashville, TN, 37203, USA,
Matern Child Health J. 2014 May;18(4):801-9. doi: 10.1007/s10995-013-1304-z.
We examined the effects of CenteringPregnancy group prenatal care versus individually delivered prenatal care on gestational age, birth weight, and fetal demise. We conducted a retrospective chart review and used propensity score matching to form a sample of 6,155 women receiving prenatal care delivered in a group or individual format at five sites in Tennessee. Compared to the matched group of women receiving prenatal care in an individual format, women in CenteringPregnancy group prenatal care had longer weeks of gestation (b = .35, 95 % CI [.29, .41]), higher birth weight in grams (b = 28.6, 95 % CI [4.8, 52.3]), lower odds of very low birth weight (OR = .21, 95 % CI [.06, .70]), and lower odds of fetal demise (OR = .12, 95 % CI [.02, .92]). Results indicated no evidence of differences in the odds of preterm birth or low birth weight for participants in group versus individual prenatal care. CenteringPregnancy group prenatal care had statistically and clinically significant beneficial effects on very low birth weight and fetal demise outcomes relative to traditional individually delivered prenatal care. Group prenatal care had statistically significant beneficial effects on gestational age and birth weight, although the effects were relatively small in clinical magnitude.
我们考察了集中孕期小组产前护理与单独提供产前护理对妊娠期、出生体重和胎儿死亡的影响。我们进行了回顾性图表审查，并使用倾向评分匹配，在田纳西州的五个地点形成了一个样本，其中 6155 名妇女以小组或个人形式接受产前护理。与接受个人形式产前护理的匹配组妇女相比，接受集中孕期小组产前护理的妇女妊娠期更长（b =.35，95 % CI [.29，.41]），出生体重更高（b = 28.6，95 % CI [4.8，52.3]），极低出生体重的几率更低（OR =.21，95 % CI [.06，.70]），胎儿死亡的几率也更低（OR =.12，95 % CI [.02，.92]）。结果表明，小组与个人产前护理相比，在早产或低出生体重的几率方面没有证据表明存在差异。与传统的单独提供的产前护理相比，集中孕期小组产前护理对极低出生体重和胎儿死亡结局具有统计学和临床意义上的有益影响。小组产前护理对妊娠期和出生体重有统计学上的显著有益影响，尽管在临床幅度上影响相对较小。
