Cluster randomized controlled trial of group prenatal care

Perinatal outcomes among adolescents in New York city health centers

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

Research output: Contribution to journalArticle

45 Citations (Scopus)

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).Weanalyzed 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.

Original languageEnglish (US)
Pages (from-to)359-365
Number of pages7
JournalAmerican Journal of Public Health
Volume106
Issue number2
DOIs
StatePublished - Feb 1 2016

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Prenatal Care
Randomized Controlled Trials
Gestational Age
Health
Parturition
Small for Gestational Age Infant
Unsafe Sex
Organizational Innovation
Pregnancy
Intention to Treat Analysis
Neonatal Intensive Care Units
Reproductive Health
Condoms
Patient Compliance
Birth Weight
Medical Records
Pregnant Women
Odds Ratio
Confidence Intervals
Costs and Cost Analysis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Ickovics, J. R., Earnshaw, V., Lewis, J. B., Kershaw, T. S., Magriples, U., Stasko, E., ... Tobin, J. N. (2016). Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers. American Journal of Public Health, 106(2), 359-365. https://doi.org/10.2105/AJPH.2015.302960

Cluster randomized controlled trial of group prenatal care : Perinatal outcomes among adolescents in New York city health centers. / Ickovics, Jeannette R.; Earnshaw, Valerie; Lewis, Jessica B.; Kershaw, Trace S.; Magriples, Urania; Stasko, Emily; Rising, Sharon Schindler; Cassells, Andrea; Cunningham, Shayna; Bernstein, Peter S.; Tobin, Jonathan N.

In: American Journal of Public Health, Vol. 106, No. 2, 01.02.2016, p. 359-365.

Research output: Contribution to journalArticle

Ickovics, JR, Earnshaw, V, Lewis, JB, Kershaw, TS, Magriples, U, Stasko, E, Rising, SS, Cassells, A, Cunningham, S, Bernstein, PS & Tobin, JN 2016, 'Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers', American Journal of Public Health, vol. 106, no. 2, pp. 359-365. https://doi.org/10.2105/AJPH.2015.302960
Ickovics, Jeannette R. ; Earnshaw, Valerie ; Lewis, Jessica B. ; Kershaw, Trace S. ; Magriples, Urania ; Stasko, Emily ; Rising, Sharon Schindler ; Cassells, Andrea ; Cunningham, Shayna ; Bernstein, Peter S. ; Tobin, Jonathan N. / Cluster randomized controlled trial of group prenatal care : Perinatal outcomes among adolescents in New York city health centers. In: American Journal of Public Health. 2016 ; Vol. 106, No. 2. pp. 359-365.
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