Group Prenatal Care Outcomes in a Military Population: A Retrospective Cohort Study.
Publication Status: Published
Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
Sponsoring Office: Walter Reed National Military Medical Center
Congressionally Mandated: No
Funding Source: Undetermined
Release Date/Publication: July 01, 2015
Principle Investigator Status: Government
Primary DoD Data Source: Other Clinical
Secondary DoD Data Source:
Abstract
OBJECTIVE:
To evaluate pregnancy outcomes in Centering Pregnancy patients.
METHODS:
This was an IRB-approved retrospective cohort study from November 2009 to January 2013 involving 202 Centering Pregnancy patients and 202 Certified Nurse Midwife patients. The primary outcome was mean gestational age at time of delivery. Secondary outcomes included cesarean and operative vaginal delivery rate, triage visit frequency, Neonatal Intensive Care Unit admission rate, 1 and 5 minute APGAR scores, birth weight, breastfeeding rate at discharge and 6 weeks postpartum, third and fourth degree laceration rate, weight gain in pregnancy, and excessive weight gain rate.
RESULTS:
There was no statistically significant difference in any obstetric outcome including preterm delivery rate. Centering Pregnancy patients were more likely to be active duty (52.0 vs. 35.6%, p = 0.001), younger (24.8 vs. 26.3 years old, p < 0.001), and nulliparous (75.2 vs. 56.9%, p < 0.001). There was a statistically significant increase in triage visit frequency ≥ 6 for Centering Pregnancy patients (11.9% vs. 8.9%, p = 0.011).
CONCLUSION:
There were no clinically significant differences in the primary or secondary outcomes. Significant cost savings could be realized by expanding Centering Pregnancy in the military health system.
Citation:
Walton RB, Shaffer S, Heaton J. Group Prenatal Care Outcomes in a Military Population: A Retrospective Cohort Study. Mil Med. 2015 Jul;180(7):825-9.