Improved Outcomes for Hispanic Women with Gestational Diabetes Using the Centering Pregnancy Group Prenatal Care Model.

Megan M Schellinger, Mary Pell Abernathy, Barbara Amerman, Carissa May, Leslie A Foxlow, Amy L Carter, Kelli Barbour, Erin Luebbehusen, Katherine Ayo, Dina Bastawros, Rebecca S Rose, David M Haas
Author Information
  1. Megan M Schellinger: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  2. Mary Pell Abernathy: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  3. Barbara Amerman: Wishard/Eskenazi Health Services Food and Nutrition Services, Indianapolis, IN, USA.
  4. Carissa May: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  5. Leslie A Foxlow: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  6. Amy L Carter: Wishard/Eskenazi Health Services Food and Nutrition Services, Indianapolis, IN, USA.
  7. Kelli Barbour: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  8. Erin Luebbehusen: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  9. Katherine Ayo: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  10. Dina Bastawros: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA.
  11. Rebecca S Rose: Division of Neonatology, Department of Pediatrics, Indianapolis, IN, USA.
  12. David M Haas: Department of Obstetrics and Gynecology, University of Indiana, 550 N. University BLVD., Ste. 2440, Indianapolis, IN, 46202, USA. dahaas@iu.edu. ORCID

Abstract

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.

Keywords

References

  1. Obstet Gynecol. 2007 Feb;109(2 Pt 1):479-80 [PMID: 17267864]
  2. Diabetologia. 2014 Dec;57(12):2465-74 [PMID: 25226881]
  3. Nutr Metab Cardiovasc Dis. 2014 Mar;24(3):263-70 [PMID: 24418374]
  4. Matern Child Health J. 2009 May;13(3):407-14 [PMID: 18465216]
  5. J Midwifery Womens Health. 2013 Jul-Aug;58(4):396-403 [PMID: 23855970]
  6. J Midwifery Womens Health. 2012 Sep-Oct;57(5):476-81 [PMID: 22954078]
  7. Obstet Gynecol. 2003 Nov;102(5 Pt 1):1051-7 [PMID: 14672486]
  8. Am J Public Health. 2009 Nov;99(11):2079-86 [PMID: 19762662]
  9. Diabetes Care. 2002 Oct;25(10):1862-8 [PMID: 12351492]
  10. Clin Obstet Gynecol. 2007 Dec;50(4):972-9 [PMID: 17982340]
  11. Curr Opin Endocrinol Diabetes Obes. 2014 Aug;21(4):257-63 [PMID: 24937039]
  12. BMC Endocr Disord. 2014 Jun 13;14:47 [PMID: 24923207]
  13. Obstet Gynecol. 2001 Sep;98(3):525-38 [PMID: 11547793]
  14. J Midwifery Womens Health. 2014 Jan-Feb;59(1):106 [PMID: 24588887]
  15. J Midwifery Womens Health. 2009 May-Jun;54(3):176-83 [PMID: 19410209]
  16. Obstet Gynecol. 2007 Aug;110(2 Pt 1):330-9 [PMID: 17666608]

MeSH Term

Adult
Breast Feeding
Cohort Studies
Diabetes, Gestational
Female
Glucose Tolerance Test
Hispanic or Latino
Humans
Patient Outcome Assessment
Pregnancy
Prenatal Care
Retrospective Studies

Word Cloud

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