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Sebastian Kaplan - One of the best experts on this subject based on the ideXlab platform.
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Psychosocial outcomes of group Prenatal Care
Journal of Public Health, 2021Co-Authors: Emily Boothe, Marta Olenderek, M. Cristina Noyola, Julia Rushing, Erinn Allred, Sebastian KaplanAbstract:Purpose Group Prenatal Care provides an alternative model of Prenatal Care that allows for collaboration with peers, education, discussion, and self-management training in addition to standard Prenatal Care. Previous research on group Prenatal Care has demonstrated a decreased risk of preterm labor and of low birth weight babies, increased pregnancy knowledge, and decreased perceived stress in certain populations. CenteringPregnancy®, an evidence-based model of group Prenatal Care, has been the focus of group Prenatal Care research, which has demonstrated such improvements in health outcomes as well as positive health behaviors. Could CenteringPregnancy® also reduce rates or severity of depression through its potential to increase support and knowledge of pregnancy for patients? This study aims to assess factors that may reduce risk of depression as well as rates of depression in women enrolled in CenteringPregnancy® compared to women in traditional, individual Care. Methods This non-randomized study collected data from patients at their initial obstetric visit and again at their postpartum visit to compare psychosocial outcomes between those participants in CenteringPregnancy® versus individual Prenatal Care. Results The majority (64%) of primiparous women chose CenteringPregnancy® (×2 = 8.6399, df = 2, p = 0.003). A significant increase in Pregnancy Knowledge Scale (PKS) scores was observed in the CenteringPregnancy® group ( p = 0.0278). Women in both groups revealed no significant difference in depression scores, as measured by the Edinburgh Postnatal Depression Scale (EPDS). Conclusions Our research adds support to current literature suggesting group Prenatal Care is equivalent to, and perhaps more beneficial (in certain psychosocial arenas) than traditional Prenatal Care (Lathrop in Nurs Womens Health 17:118–130, 2013 ).
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Psychosocial outcomes of group Prenatal Care
Journal of Public Health, 2021Co-Authors: Emily Boothe, Marta Olenderek, M. Cristina Noyola, Julia Rushing, Erinn Allred, Sebastian KaplanAbstract:Group Prenatal Care provides an alternative model of Prenatal Care that allows for collaboration with peers, education, discussion, and self-management training in addition to standard Prenatal Care. Previous research on group Prenatal Care has demonstrated a decreased risk of preterm labor and of low birth weight babies, increased pregnancy knowledge, and decreased perceived stress in certain populations. CenteringPregnancy®, an evidence-based model of group Prenatal Care, has been the focus of group Prenatal Care research, which has demonstrated such improvements in health outcomes as well as positive health behaviors. Could CenteringPregnancy® also reduce rates or severity of depression through its potential to increase support and knowledge of pregnancy for patients? This study aims to assess factors that may reduce risk of depression as well as rates of depression in women enrolled in CenteringPregnancy® compared to women in traditional, individual Care. This non-randomized study collected data from patients at their initial obstetric visit and again at their postpartum visit to compare psychosocial outcomes between those participants in CenteringPregnancy® versus individual Prenatal Care. The majority (64%) of primiparous women chose CenteringPregnancy® (×2 = 8.6399, df = 2, p = 0.003). A significant increase in Pregnancy Knowledge Scale (PKS) scores was observed in the CenteringPregnancy® group (p = 0.0278). Women in both groups revealed no significant difference in depression scores, as measured by the Edinburgh Postnatal Depression Scale (EPDS). Our research adds support to current literature suggesting group Prenatal Care is equivalent to, and perhaps more beneficial (in certain psychosocial arenas) than traditional Prenatal Care (Lathrop in Nurs Womens Health 17:118–130, 2013).
Greg R. Alexander - One of the best experts on this subject based on the ideXlab platform.
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The changing pattern of Prenatal Care utilization in the United States, 1981-1995, using different Prenatal Care indices.
JAMA, 1998Co-Authors: Michael D. Kogan, Joyce A Martin, Greg R. Alexander, Milton Kotelchuck, Stephanie J. Ventura, Fredric D. FrigolettoAbstract:Context.—Two measures traditionally used to examine adequacy of Prenatal Care indicate that Prenatal Care utilization remained unchanged through the 1980s and only began to rise slightly in the 1990s. In recent years, new measures have been developed that include a category for women who receive more than the recommended amount of Care (intensive utilization).Objective.—To compare the older and newer indices in the monitoring of Prenatal Care trends in the United States from 1981 to 1995, for the overall population and for selected subpopulations. Second, to examine factors associated with receiving intensive utilization.Design.—Cross-sectional and trend analysis of national birth records.Setting.—The United States.Subjects.—All live births between 1981 and 1995 (N=54 million).Main Outcome Measures.—Trends in Prenatal Care utilization, according to 4 indices (the older indices: the Institute of Medicine Index and the trimester that Care began, and the newer indices: the R-GINDEX and the Adequacy of Prenatal Care Utilization Index). Multiple logistic regression was used to assess the risk of intensive Prenatal Care use in 1981 and 1995.Results.—The newer indices showed a steadily increasing trend toward more Prenatal Care use throughout the study period (R-GINDEX, intensive or adequate use, 32.7% in 1981 to 47.1% in 1995; the Adequacy of Prenatal Care Utilization Index, intensive use, 18.4% in 1981 to 28.8% in 1995), especially for intensive utilization. Women having a multiple birth were much more likely to have had intensive utilization in 1995 compared with 1981 (R-GINDEX, 22.8% vs 8.5%). Teenagers were more likely to begin Care later than adults, but similar proportions of teens and adults had intensive utilization. Intensive use among low-risk women also increased steadily each year. Factors associated with a greater likelihood of receiving intensive use in 1981 and 1995 were having a multiple birth, primiparity, being married, and maternal age of 35 years or older.Conclusions.—The proportion of women who began Care early and received at least the recommended number of visits increased between 1981 and 1995. This change was undetected by more traditional Prenatal Care indices. These increases have cost and practice implications and suggest a paradox since previous studies have shown that rates of preterm delivery and low birth weight did not improve during this time.
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Quantifying the adequacy of Prenatal Care: a comparison of indices.
Public health reports (Washington D.C. : 1974), 1996Co-Authors: Greg R. Alexander, Milton KotelchuckAbstract:Abstract OBJECTIVES: In spite of the widespread use of Prenatal Care utilization indices in the scientific literature, little attention has been given to the extent to which these indices are comparable. This investigation contrasts the way five indices classified cases into categories of Prenatal Care use. METHODS: From the 1989-1991 South Carolina Public Use data files, single live births to resident mothers were selected for analysis (N = 169,082). Five Prenatal Care indices were compared: (a) the modified Institute of Medicine (Kessner) index, (b) a variation of the IOM index using the full American College of Obstetrics and Gynecology visit recommendation, (c) an index derived from the recommendations of the U.S. Public Health Service Expert Panel on Prenatal Care, (d) the GINDEX, and (e) the APNCU index. RESULTS: The proportion of cases assigned to Prenatal Care utilization categories by each index varied markedly, ranging from 33.6% to 58.1% for adequate Care, 9.2% to 20.3% for inadequate Care, and 7.4% to 22.6% for intensive utilization. CONCLUSIONS: The selection of a Prenatal Care utilization index for research and policy development purposes requires a Careful consideration of the intent, criteria for defining adequacy, and coding assumptions of each index. As these indices are conceptually distinct in their measurement approach, they are likely to yield different patterns of Prenatal Care use in a population and cannot be used interchangeably. Recommendations for their use are provided.
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the role of Prenatal Care in preventing low birth weight
The Future of Children, 1995Co-Authors: Greg R. Alexander, Carol C KorenbrotAbstract:Prenatal Care has long been endorsed as a means to identify mothers at risk of delivering a preterm or growth-retarded infant and to provide an array of available medical, nutritional, and educational interventions intended to reduce the determinants and incidence of low birth weight and other adverse pregnancy conditions and outcomes. Although the general notion that Prenatal Care is of value to both mother and child became widely accepted in this century, the empirical evidence supporting the association between Prenatal Care and reduced rates of low birth weight emerged slowly and has been equivocal. Much of the controversy over the effectiveness of Prenatal Care in preventing low birth weight stems from difficulties in defining what constitutes Prenatal Care and adequate Prenatal Care use. While the collective evidence regarding the efficacy of Prenatal Care to prevent low birth weight continues to be mixed, the literature indicates that the most likely known targets for Prenatal interventions to prevent low birth weight rates are (1) psychosocial (aimed at smoking); (2) nutritional (aimed at low prepregnancy weight and inadequate weight gain); and (3) medical (aimed at general morbidity). System level approaches to impact the accessibility and the appropriateness of Prenatal health Care services to entire groups of women and population-wide health promotion, social service, and case management approaches may also offer potential benefits. However, data on the effectiveness of these services are lacking, and whether interventions focused on building cohesive, functional communities can do as much or more to improve low birth weight rates as individualized treatments has yet to be explored. The ultimate success of Prenatal Care in substantially reducing current low birth weight percentages in the United States may hinge on the development of a much broader and more unified conception of Prenatal Care than currently prevails. Recommendations for actions to maximize the impact of Prenatal Care on reducing low birth weight are proposed both for the public and for the biomedical, public health, and research communities.
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relation of the content of Prenatal Care to the risk of low birth weight maternal reports of health behavior advice and initial Prenatal Care procedures
JAMA, 1994Co-Authors: Michael D. Kogan, Greg R. Alexander, Milton Kotelchuck, David A NageyAbstract:Objective. —Numerous studies have found a relationship between the quantity of Prenatal Care received and birth outcomes. Few studies have had the opportunity to examine the content of Prenatal Care. This study examined the relationship between two components of the content of Prenatal Care: maternal reports of health behavior advice received and initial Prenatal Care procedures performed during the first two visits and low birth weight in a national sample of women. Advice and initial procedures were categorized based on the recommendations of the US Public Health Service Expert Panel on the Content of Prenatal Care. Design. —Interview survey of a nationally representative sample of women who had live births in 1988. Participants. —A total of 9394 women, with data from the National Maternal and Infant Health Survey. Main Outcome Measure. —Low birth weight ( Results. —After controlling for other sociodemographic, utilization, medical, and behavioral factors, women who reported not receiving all the types of advice recommended by the Expert Panel on the Content of Prenatal Care were more likely to have a low—birth-weight infant compared with women who reported receiving the optimal level of advice (odds ratio=1.38; 95% confidence interval, 1.18 to 1.60). There were no differences between women who reported receiving all the recommended initial Prenatal Care procedures and those who reported not receiving all recommended Prenatal Care (odds ratio=1.00; 95% confidence interval, 0.87 to 1.14). Conclusion. —These data suggest that women who report receiving sufficient health behavior advice as part of their Prenatal Care are at lower risk of delivering a low—birth-weight infant. ( JAMA . 1994;271:1340-1345)
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Prenatal Care and prematurity: is there an association in uncomplicated pregnancies?
Birth (Berkeley Calif.), 1991Co-Authors: Thomas C. Hulsey, Greg R. Alexander, Celeste H. Patrick, Myla EbelingAbstract:A retrospective investigation examined patterns of use of Prenatal Care and pregnancy outcomes (low birthweight and preterm births) in 6176 pregnancies without antepartum medical complications. Prenatal Care use patterns differed significantly by mother's age, marital status, race, education, method of payment, and gravidity. By controlling for these differences through a logistic regression procedure, results showed that Prenatal Care was associated with significant reductions in the number of infants who were delivered preterm or had low birthweight. Fewer very low-birthweight (less than 1500 g) infants were among the preterm infants delivered to mothers with Prenatal Care compared with women who received no Prenatal Care. These data suggest that significant improvements in pregnancy outcomes are seen among women who use Prenatal Care, and these benefits occur in the absence of antepartum complications.
Emily Boothe - One of the best experts on this subject based on the ideXlab platform.
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Psychosocial outcomes of group Prenatal Care
Journal of Public Health, 2021Co-Authors: Emily Boothe, Marta Olenderek, M. Cristina Noyola, Julia Rushing, Erinn Allred, Sebastian KaplanAbstract:Purpose Group Prenatal Care provides an alternative model of Prenatal Care that allows for collaboration with peers, education, discussion, and self-management training in addition to standard Prenatal Care. Previous research on group Prenatal Care has demonstrated a decreased risk of preterm labor and of low birth weight babies, increased pregnancy knowledge, and decreased perceived stress in certain populations. CenteringPregnancy®, an evidence-based model of group Prenatal Care, has been the focus of group Prenatal Care research, which has demonstrated such improvements in health outcomes as well as positive health behaviors. Could CenteringPregnancy® also reduce rates or severity of depression through its potential to increase support and knowledge of pregnancy for patients? This study aims to assess factors that may reduce risk of depression as well as rates of depression in women enrolled in CenteringPregnancy® compared to women in traditional, individual Care. Methods This non-randomized study collected data from patients at their initial obstetric visit and again at their postpartum visit to compare psychosocial outcomes between those participants in CenteringPregnancy® versus individual Prenatal Care. Results The majority (64%) of primiparous women chose CenteringPregnancy® (×2 = 8.6399, df = 2, p = 0.003). A significant increase in Pregnancy Knowledge Scale (PKS) scores was observed in the CenteringPregnancy® group ( p = 0.0278). Women in both groups revealed no significant difference in depression scores, as measured by the Edinburgh Postnatal Depression Scale (EPDS). Conclusions Our research adds support to current literature suggesting group Prenatal Care is equivalent to, and perhaps more beneficial (in certain psychosocial arenas) than traditional Prenatal Care (Lathrop in Nurs Womens Health 17:118–130, 2013 ).
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Psychosocial outcomes of group Prenatal Care
Journal of Public Health, 2021Co-Authors: Emily Boothe, Marta Olenderek, M. Cristina Noyola, Julia Rushing, Erinn Allred, Sebastian KaplanAbstract:Group Prenatal Care provides an alternative model of Prenatal Care that allows for collaboration with peers, education, discussion, and self-management training in addition to standard Prenatal Care. Previous research on group Prenatal Care has demonstrated a decreased risk of preterm labor and of low birth weight babies, increased pregnancy knowledge, and decreased perceived stress in certain populations. CenteringPregnancy®, an evidence-based model of group Prenatal Care, has been the focus of group Prenatal Care research, which has demonstrated such improvements in health outcomes as well as positive health behaviors. Could CenteringPregnancy® also reduce rates or severity of depression through its potential to increase support and knowledge of pregnancy for patients? This study aims to assess factors that may reduce risk of depression as well as rates of depression in women enrolled in CenteringPregnancy® compared to women in traditional, individual Care. This non-randomized study collected data from patients at their initial obstetric visit and again at their postpartum visit to compare psychosocial outcomes between those participants in CenteringPregnancy® versus individual Prenatal Care. The majority (64%) of primiparous women chose CenteringPregnancy® (×2 = 8.6399, df = 2, p = 0.003). A significant increase in Pregnancy Knowledge Scale (PKS) scores was observed in the CenteringPregnancy® group (p = 0.0278). Women in both groups revealed no significant difference in depression scores, as measured by the Edinburgh Postnatal Depression Scale (EPDS). Our research adds support to current literature suggesting group Prenatal Care is equivalent to, and perhaps more beneficial (in certain psychosocial arenas) than traditional Prenatal Care (Lathrop in Nurs Womens Health 17:118–130, 2013).
William A. Grobman - One of the best experts on this subject based on the ideXlab platform.
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Association of Gestational Weight Gain with Prenatal Care Model.
Journal of midwifery & women's health, 2018Co-Authors: Michelle A. Kominiarek, Elizabeth L Gray, Heidi Vyhmeister, William A. Grobman, Melissa A. SimonAbstract:INTRODUCTION The objective of this study was to compare gestational weight gain (GWG) among women in group and traditional Prenatal Care. METHODS This is a retrospective cohort study of women who received Prenatal Care between 2011 and 2015 in a setting in which low-risk women had the option of group Prenatal Care. Women with height and initial and final weight were eligible. Women who chose group Prenatal Care were compared with women who chose traditional Prenatal Care and gave birth during the same study period. A propensity score analysis was used to create a matched control group from women who received traditional Prenatal Care. Bivariable comparisons of demographics, maternal characteristics, and GWG as a categorical variable (inadequate, adequate, or excessive per the 2009 Institute of Medicine guidelines) were performed with chi-square or Wilcoxon rank-sum tests. A logistic regression analysis was performed to estimate the association of group Prenatal Care with excessive GWG. RESULTS The final sample included 818 women who received either group or traditional Prenatal Care and were matched according to age, body mass index (BMI), nulliparity, and marital status. In the unadjusted analysis, women in group Prenatal Care had lower odds of excessive GWG (odds ratio [OR], 0.75; 95% CI, 0.57-0.99), but the statistical significance of this finding did not persist in the adjusted analysis (OR, 0.77; 95% CI, 0.45-1.30). When the analyses were limited to women who had at least 5 group or traditional Prenatal Care visits, there were no differences in excessive GWG in unadjusted (OR, 0.83; 95% CI, 0.59-1.16) or adjusted (OR, 0.97; 95% CI, 0.24-3.96) analyses. DISCUSSION In this propensity score matched cohort study of predominantly Hispanic women, there were no differences in excessive GWG between women in group compared with traditional Prenatal Care. Further study is indicated to determine the relationship between Prenatal Care model and GWG outcomes.
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Association of Group Prenatal Care With Gestational Weight Gain.
Obstetrics and gynecology, 2017Co-Authors: Michelle A. Kominiarek, Melissa A. Simon, Amy Crockett, Sarah Covington-kolb, William A. GrobmanAbstract:OBJECTIVE To compare gestational weight gain among women in group Prenatal Care with that of women in individual Prenatal Care. METHODS In this retrospective cohort study, women who participated in group Prenatal Care from 2009 to 2015 and whose body mass indexes (BMIs) and gestational weight gain were recorded were matched with the next two women who had the same payer type, were within 2-kg/m prepregnancy BMI and 2-week gestational age at delivery, and had received individual Prenatal Care. Bivariate comparisons of demographics and antenatal complications were performed for women in group and individual Prenatal Care, and weight gain was categorized as "below," "met," or "exceeded" goals according to the 2009 Institute of Medicine guidelines. Logistic regression analysis estimated the association between excessive weight gain and model of Care, with adjustment for confounders, stratified by BMI. RESULTS Women in group Prenatal Care (n=2,117) were younger and more commonly non-Hispanic black, nulliparous, and without gestational diabetes (P≤.005 for all). Women in group Prenatal Care more commonly exceeded the weight gain goals (55% compared with 48%, P
Carol C Korenbrot - One of the best experts on this subject based on the ideXlab platform.
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the role of Prenatal Care in preventing low birth weight
The Future of Children, 1995Co-Authors: Greg R. Alexander, Carol C KorenbrotAbstract:Prenatal Care has long been endorsed as a means to identify mothers at risk of delivering a preterm or growth-retarded infant and to provide an array of available medical, nutritional, and educational interventions intended to reduce the determinants and incidence of low birth weight and other adverse pregnancy conditions and outcomes. Although the general notion that Prenatal Care is of value to both mother and child became widely accepted in this century, the empirical evidence supporting the association between Prenatal Care and reduced rates of low birth weight emerged slowly and has been equivocal. Much of the controversy over the effectiveness of Prenatal Care in preventing low birth weight stems from difficulties in defining what constitutes Prenatal Care and adequate Prenatal Care use. While the collective evidence regarding the efficacy of Prenatal Care to prevent low birth weight continues to be mixed, the literature indicates that the most likely known targets for Prenatal interventions to prevent low birth weight rates are (1) psychosocial (aimed at smoking); (2) nutritional (aimed at low prepregnancy weight and inadequate weight gain); and (3) medical (aimed at general morbidity). System level approaches to impact the accessibility and the appropriateness of Prenatal health Care services to entire groups of women and population-wide health promotion, social service, and case management approaches may also offer potential benefits. However, data on the effectiveness of these services are lacking, and whether interventions focused on building cohesive, functional communities can do as much or more to improve low birth weight rates as individualized treatments has yet to be explored. The ultimate success of Prenatal Care in substantially reducing current low birth weight percentages in the United States may hinge on the development of a much broader and more unified conception of Prenatal Care than currently prevails. Recommendations for actions to maximize the impact of Prenatal Care on reducing low birth weight are proposed both for the public and for the biomedical, public health, and research communities.
