979: The effect of Diabetes Group Prenatal Care on Pregnancy Outcomes: a pilot randomized controlled trial

Abstract

To determine whether women with Type 2 (T2DM) and gestational diabetes (GDM) participating in group prenatal care (GPNC) have improved pregnancy outcomes compared to women receiving individual prenatal care. A two-center pilot randomized controlled trial was conducted at Denver Health (DH) and Washington University in St. Louis (WU). Inclusion criteria included Spanish (DH) or English (WU) speaking, T2DM or GDM diagnosed by the 2 step method ≤32 weeks, gestational age at first study visit 22-34 weeks, ability to attend GPNC at specified days/times, and willingness to be randomized. Exclusion criteria included type 1 diabetes, multiple gestation, major fetal anomaly, serious medical co-morbidity or serious psychiatric illness. Women were randomized to Diabetes GPNC or individual prenatal care (IPNC). GPNC included bi-weekly 2-hour sessions in which a diabetes, pregnancy and behavioral health topic were addressed through activities using group process and adult-learning principles.. A diabetes, pregnancy and behavioral health topic were addressed in each session through activities using group process and adult-learning principles. Pregnancy, neonatal and postpartum outcomes were compared between groups. Analysis was by intention to treat (clincaltrials.gov# NCT02444325). There were no differences in demographic characteristics between groups. Pregnancy, neonatal, and postpartum outcomes were similar in women participating in GPNC compared to IPNC. Among 40 participants with GDM, women randomized to GPNC were significantly more likely to return for postpartum glucose challenge testing than women in IPNC (70% vs 25%, p=0.004, RR 2.50; 95% CI 1.22-5.11). This pilot trial confirms the feasibility of a definitive trial of GPNC in women with diabetes. Among women with GDM, GPNC is a promising intervention to increase rates of postpartum screening.