Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Feb;106(2):359-65.
doi: 10.2105/AJPH.2015.302960. Epub 2015 Dec 21.

Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

Jeannette R Ickovics  1 , Valerie Earnshaw  1 , Jessica B Lewis  1 , Trace S Kershaw  1 , Urania Magriples  1 , Emily Stasko  1 , Sharon Schindler Rising  1 , Andrea Cassells  1 , Shayna Cunningham  1 , Peter Bernstein  1 , Jonathan N Tobin  1
Affiliations
Randomized Controlled Trial

Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

Jeannette R Ickovics et al. Am J Public Health. 2016 Feb.

Abstract

Objectives: We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes.

Methods: We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008-2012). We analyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys.

Results: In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (< 10th percentile; 11.0% vs 15.8%; odds ratio = 0.66; 95% confidence interval = 0.44, 0.99). In as-treated analyses, women with more group visits had better outcomes, including small for gestational age, gestational age, birth weight, days in neonatal intensive care unit, rapid repeat pregnancy, condom use, and unprotected sex (P = .030 to < .001). There were no associated risks.

Conclusions: CenteringPregnancy Plus group prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
CONSORT Diagram for Cluster Randomized Controlled Trials: Group Prenatal Care Study, New York, NY, 2008–2011 Note. CONSORT = Consolidated Standards of Reporting Trials. aThere were 35 women enrolled at this cluster or clinical site before discontinuation. We included these women in all analyses per intention-to-treat principles. bOne woman in each condition met > 1 exclusion criterion.
See this image and copyright information in PMC

References

    1. Ickovics JR. “Bundling” HIV prevention: integrating services to promote synergistic gain. Prev Med. 2008;46(3):222–225. - PMC - PubMed
    1. Schweizer M, Perencevich E, McDanel J et al. Effectiveness of a bundled intervention of decolonization and prophylaxis to decrease Gram positive surgical site infections after cardiac or orthopedic surgery: systematic review and meta-analysis. BMJ. 2013;346:f2743. - PMC - PubMed
    1. Behrman RE, Butler AS US Institute of Medicine, Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Preterm Birth: Causes, Consequences and Prevention. Washington, DC: National Academies Press; 2007. - PubMed
    1. Braveman PA, Heck K, Egerter S et al. The role of socioeconomic factors in Black–White disparities in preterm birth. Am J Public Health. 2015;105:694–702. - PMC - PubMed
    1. Meade CS, Ickovics JR. Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy. Soc Sci Med. 2005;60(4):661–678. - PubMed

Publication types