Centering Prenatal Care

Abstract

INTRODUCTION: The Centering Pregnancy prenatal care model is a group care model which incorporates standard prenatal assessment and education into a series of sessions in which patients are encouraged to participate in their own healthcare and learn from their peers. The aim of this study was to compare outcomes for traditional care patients at one high volume health center with the institution's Centering Pregnancy patients, focusing on preterm birth. METHODS: This study is a retrospective cohort analysis of 5,003 traditional care and 444 Centering Pregnancy deliveries at Christiana Care Health Services from 2009 until 2014. Eligible patients initiated care in the first trimester with the resident hospital service. Parity, race, and prior preterm birth were controlled for. RESULTS: Mean gestational age at delivery was significantly higher in the Centering Pregnancy cohort (38.67 vs 38.15, P=.0004). After correction for parity, race, and prior preterm delivery, Centering Pregnancy was protective for preterm delivery before 34 weeks (OR: .43, P=.006). There also was a nonsignificant trend towards lower rates of preterm delivery before 37 weeks in the Centering Pregnancy cohort (OR: .73, P=.062). NICU admission was higher in the traditional care group (18.31% vs 12.61%). Birthweight and five minute APGAR of 9 were similar between groups. CONCLUSION: This large retrospective study shows decreased preterm birth rates with Centering Pregnancy in an at risk population. The clinician should be open to providing prenatal care outside of the traditional framework, especially for disadvantaged patients at high risk of poor pregnancy outcome.