MCN Am J Matern Child Nurs. 2021;46(6):314-322. doi: 10.1097/NMC.0000000000000766.
The objective of this study was to examine the current state of literature on group prenatal care and its impact on maternal outcomes and racial disparities in adverse maternal outcomes.
We conducted a scoping review of literature published between January 2010 and December 2020 using the PRISMA-ScR reporting checklist.
Eligible studies were identified using key words and MeSH terms in PubMed, CINAHL, and Web of Science. Inclusion criteria were studies that were (a) conducted in the United States; (b) published between January 2010 and December 2020; (c) in English; (d) focused on the primary investigation of group prenatal care and reporting on maternal comorbidity outcomes; and (e) an observational study or clinical trial.
Nine studies met inclusion criteria. They reported on outcomes of preeclampsia, gestational hypertension, gestational diabetes mellitus, final A1C among patients with gestational diabetes mellitus, and postpartum hemorrhage. None reported on racial disparities for minoritized populations. Among all reported maternal outcomes, results were mixed, providing inconclusive evidence.
Outcomes from group prenatal care focus more on neonatal outcomes than maternal outcomes. More studies are needed with stronger designs. Given pervasive racial disparities in U.S. maternal mortality, future studies should assess how group prenatal care participation may contribute to fewer experiences of racial discrimination and implicit bias for Black women in maternity care.
本研究旨在考察群体产前护理文献的现状及其对产妇结局和不良产妇结局中种族差异的影响。
我们使用 PRISMA-ScR 报告清单，对 2010 年 1 月至 2020 年 12 月期间发表的文献进行了范围综述。
我们在 PubMed、CINAHL 和 Web of Science 中使用关键词和 MeSH 术语来确定符合条件的研究。纳入标准为：（a）在美国进行的研究；（b）发表于 2010 年 1 月至 2020 年 12 月期间；（c）用英文撰写的研究；（d）主要关注群体产前护理的初步调查，并报告产妇合并症结局；（e）观察性研究或临床试验。
符合纳入标准的有 9 项研究。它们报告了子痫前期、妊娠高血压、妊娠糖尿病、妊娠糖尿病患者的最终 A1C 和产后出血的结局。没有一项研究报告了少数族裔人群的种族差异。在所有报告的产妇结局中，结果参差不齐，提供的证据不确定。
群体产前护理的结果更关注新生儿结局，而不是产妇结局。需要更多设计更强大的研究。鉴于美国产妇死亡率普遍存在种族差异，未来的研究应评估群体产前护理的参与情况如何可能减少黑人妇女在产妇护理中经历种族歧视和隐性偏见的次数。
