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

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.