Schellinger Megan M, Abernathy Mary Pell, Amerman Barbara, May Carissa, Foxlow Leslie A, Carter Amy L, Barbour Kelli, Luebbehusen Erin, Ayo Katherine, Bastawros Dina, Rose Rebecca S, Haas David M
Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
Wishard/Eskenazi Health Services Food and Nutrition Services, Indianapolis, IN, USA.
Matern Child Health J. 2017 Feb;21(2):297-305. doi: 10.1007/s10995-016-2114-x.
Objective To determine the impact of Centering Pregnancy-based group prenatal care for Hispanic gravid diabetics on pregnancy outcomes and postpartum follow-up care compared to those receiving traditional prenatal care. Methods A cohort study was performed including 460 women diagnosed with gestational diabetes mellitus (GDM) who received traditional or Centering Pregnancy prenatal care. The primary outcome measured was completion of postpartum glucose tolerance testing. Secondary outcomes included postpartum visit attendance, birth outcomes, breastfeeding, and initiation of a family planning method. Results 203 women received Centering Pregnancy group prenatal care and 257 received traditional individual prenatal care. Women receiving Centering Pregnancy prenatal care were more likely to complete postpartum glucose tolerance testing than those receiving traditional prenatal care, (83.6 vs. 60.7 %, respectively; p < 0.001), had a higher rate of breastfeeding initiation (91.0 vs. 69.4 %; p < 0.001), had higher rates of strictly breastfeeding at their postpartum visit (63.1 vs. 46.3 %; p = 0.04), were less likely to need medical drug therapy compared to traditional prenatal care (30.2 vs. 42.1 %; p = 0.009), and were less likely to undergo inductions of labor (34.5 vs. 46.2 %; p = 0.014). When only Hispanic women were compared, women in the Centering group continued to have higher rates of breastfeeding and completion of postpartum diabetes screening. Conclusion for Practice Hispanic women with GDM who participate in Centering Pregnancy group prenatal care may have improved outcomes.
目的 确定与接受传统产前护理的西班牙裔妊娠糖尿病孕妇相比，基于“孕期中心”模式的小组产前护理对妊娠结局和产后随访护理的影响。方法 进行了一项队列研究，纳入460名被诊断为妊娠期糖尿病（GDM）并接受传统或“孕期中心”产前护理的妇女。测量的主要结局是产后葡萄糖耐量试验的完成情况。次要结局包括产后就诊情况、分娩结局、母乳喂养和计划生育方法的开始使用。结果 203名妇女接受了“孕期中心”小组产前护理，257名接受了传统的个体产前护理。接受“孕期中心”产前护理的妇女比接受传统产前护理的妇女更有可能完成产后葡萄糖耐量试验（分别为83.6%和60.7%；p<0.001），母乳喂养开始率更高（91.0%对69.4%；p<0.001），产后就诊时纯母乳喂养率更高（63.1%对46.3%；p=0.04），与传统产前护理相比，需要药物治疗的可能性更小（30.2%对42.1%；p=0.009），引产的可能性更小（34.5%对46.2%；p=0.014）。仅比较西班牙裔妇女时，“孕期中心”组的妇女母乳喂养率和产后糖尿病筛查完成率仍然更高。实践结论 参与“孕期中心”小组产前护理的患有GDM的西班牙裔妇女可能会有更好的结局。
