Risisky Deb, Chan Ronna L, Zigmont Victoria A, Asghar Syed Masood, DeGennaro Nancy
Department of Public Health, Southern Connecticut State University, 501 Crescent Street, New Haven, CT, 06514, USA.
Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Matern Child Health J. 2018 Feb;22(2):274-282. doi: 10.1007/s10995-017-2400-2.
Introduction The purpose of the study is to evaluate delivery method and breastfeeding initiation in women enrolled in group prenatal care (CenteringPregnancy) and in traditional prenatal care. Methods Data were obtained from medical records of a hospital-based midwifery practice in south central Connecticut that offered both types of prenatal care programs. Medical information from 307 women enrolled in this practice was included in the analysis. Out of the 307, 80 were enrolled in group prenatal care. Socio-demographic, lifestyle, and previous and current obstetrical information from medical records formed the basis of comparison. Bivariate and logistic regression analyses were carried out. Results Women in Centering had fewer planned cesarean sections (1.3 vs. 12.8%) and had a higher breastfeeding initiation (88.7 vs. 80.0%). However, Centering women were found to have a higher portion of unplanned cesarean sections (27.5 vs. 11.0%). Both the unadjusted and the adjusted odds ratios of having a cesarean planned delivery were lower in the group care. Women in Centering had 2.44 (95% CI 1.05, 5.66) times the odds of breastfeeding initiation compared to the odds for women in traditional prenatal care after adjusting for maternal age, smoking status, gestation and race. Discussion CenteringPregnancy can have positive impact for the woman and baby. This program implementation saw lower rates of elective cesarean sections and increased breastfeeding compared to women in traditional care.
引言 本研究的目的是评估参加群组产前护理（CenteringPregnancy）和传统产前护理的女性的分娩方式和母乳喂养开始情况。方法 数据来自康涅狄格州中南部一家提供两种产前护理项目的医院助产实践的病历。分析纳入了该实践中307名女性的医疗信息。在这307名女性中，80名参加了群组产前护理。病历中的社会人口统计学、生活方式以及既往和当前的产科信息构成了比较的基础。进行了双变量和逻辑回归分析。结果 参加Centering的女性计划剖宫产的比例较低（1.3%对12.8%），母乳喂养开始率较高（88.7%对80.0%）。然而，发现参加Centering的女性非计划剖宫产的比例较高（27.5%对11.0%）。在群组护理中，计划剖宫产分娩的未调整和调整后的优势比均较低。在调整了产妇年龄、吸烟状况、孕周和种族后，参加Centering的女性母乳喂养开始的几率是传统产前护理女性的2.44倍（95%可信区间1.05，5.66）。讨论 CenteringPregnancy对母婴可能有积极影响。与接受传统护理的女性相比，该项目实施后择期剖宫产率较低，母乳喂养率增加。
