Group prenatal care vs traditional prenatal care
Group prenatal care may lower the risk of preterm birth in African American women.
Pregnant women who participate in group prenatal care have similar rates of preterm birth, neonatal intensive care unit admission, and breastfeeding as those who have traditional prenatal care, according to a study in the September issue of Obstetrics & Gynecology.
Ebony Carter, MD, MPH, from the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Washington University School of Medicine in St. Louis, and colleagues searched electronic databases for randomized controlled trials and observational studies that compared group care and traditional prenatal care. The study's primary outcome was preterm birth, and secondary outcomes were low birth weight, neonatal intensive care unit admission, and the initiation of breastfeeding.
The researchers ultimately included 4 randomized controlled trials and 10 observational studies in their analysis. According to the investigators, the rate of preterm birth for group care “was not significantly different when compared with traditional care” (11 studies: pooled rate, 7.9% for group care vs 9.3% for traditional care; pooled relative risk [RR], 0.87). Group care was associated with a lower rate of low birth weight overall (9 studies: pooled rate, 7.5% for group care vs 9.5% for traditional care; pooled RR, 0.81). However, this finding was not observed in the randomized controlled trials (4 studies: 7.9% for group care vs 8.7% for traditional care; pooled RR, 0.92). No significant differences in neonatal intensive care unit admission or breastfeeding initiation were observed.
“Results of this systematic review and meta-analysis indicate that participation in group prenatal care was not associated with lower rates of preterm birth, neonatal intensive care unit admission, or breastfeeding initiation overall or by study design,” stated Dr Carter and colleagues. “Group prenatal care may decrease the risk of preterm birth in African American women. Importantly, there is no evidence that group care causes harm.
“This alternative form of prenatal care warrants further study, especially with regard to postpartum maternal outcomes and in African American women,” the researchers concluded. “In addition, studies are needed to assess the effects of group care in high-risk women such as those with obesity or diabetes.”
Carter EB, Temming LA, Akin J, et al. Group prenatal care compared with traditional prenatal care: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(3):551-561. doi: 10.1097/AOG.0000000000001560.