Association of Gestational Weight Gain with Prenatal Care Model.
Michelle A Kominiarek, Elizabeth Lucio Gray, Heidi Vyhmeister and 2 others
PMID 29758122WHAT IT FOUND
Group prenatal care did not improve whether weight gain was in the recommended range after accounting for baseline factors.
The lower rate of excessive gain seen before accounting disappeared once age, body mass index, parity, visits and gestational age were considered.
Key findings
01Adequacy of gestational weight gain did not differ between CenteringPregnancy and traditional prenatal care: 25% inadequate, 32% adequate, 43% excessive versus 20% inadequate, 29% adequate, 50% excessive (P=.10).
02Excessive gestational weight gain was less common before adjustment (43% versus 50%; OR, 0.75; 95% CI, 0.57 to 0.99), but the adjusted association was not statistically significant (OR, 0.77; 95% CI, 0.45 to 1.30).
03Restricting the analysis to women with at least 5 prenatal visits (n=536 total; 268 in each group) still showed no significant association between CenteringPregnancy and excessive gestational weight gain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a nonrandomized observational study, so women who chose group care may have differed in ways not captured by matching. Pre-pregnancy weight was unavailable, so only women starting prenatal care in the first trimester with early weight were included; about 10% of the original cohort was excluded. Diet, exercise, food access, cultural beliefs, provider type, language and education were not measured, so the study cannot say which parts of care or life circumstances mattered. Women were counted as receiving CenteringPregnancy if they attended at least one session, and the site reported a median of 6 out of 10 sessions attended. Only 22 underweight women were excluded in one sensitivity analysis, so that analysis says little about underweight women.
Declared interests
The authors report no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that group prenatal care reduces excessive gestational weight gain. The lower rate seen before accounting did not persist after adjustment, and restricting to women with at least five visits also showed no significant association.