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COMPARISON OF TRADITIONAL ANTENATAL CARE AND CENTERINGPREGNANCY®: MATERNAL AND INFANTS OUTCOMES
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dissertation
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University of Wisconsin-Milwaukee
Abstract
Background: Despite progress in antenatal care (ANC), maternal and infant health disparitiespersist, especially among socioeconomically marginalized populations. Traditional Antenatal Care (TAC), though effective for clinical monitoring, often lacks structured education and psychosocial support. CenteringPregnancy®, a group-based ANC, integrates clinical care with peer interaction and education, potentially improving outcomes. However, evidence comparing these ANC models in a racially diversed U.S. settings remains limited. Methods: The study include 1,952 pregnant mothers (976 TAC and 976 CenteringPregnancy®). This quasi-experimental secondary data analysis used PeriData.Net® records from a Midwestern healthcare facility to compare maternal outcomes (cesarean birth, postpartum hemorrhage [PPH], postpartum infection [P-UTI]) and infant outcomes (preterm birth and low birth weight [LBW]) between TAC and CenteringPregnancy®. Logistic regression models assessed direct effects and effect modification by maternal characteristics including age, parity, race, gestational diabetes mellitus (GDM), and gestational hypertension (GHTN). Results: In the unadjusted analysis, CenteringPregnancy® was associated with overall improved outcomes including lower risks of cesarean birth, PPH, preterm birth, LBW, and P-UTI. However, several associations lost statistical significance after adjusting for the maternal characteristics, indicating that age, parity, GDM, and GHTN significantly modified these relationships. Older mothers and mothers with GHTN remained at highest risk for adverse outcomes across both ANC models. CenteringPregnancy® demonstrated the strongest benefits for multiparous mothers. likely through enhanced education, reduced anxiety, and improved self- efficacy. No significant racial differences were detected within the CenteringPregnancy® group. Conclusions: CenteringPregnancy® shows promise as a patientcentered model that may improve maternal and infant outcomes, particularly for mothers with specific health risk profiles. While benefits of CenteringPregnancy® varies based on maternal characteristics, the model’s peer support and structured education components highlight its potential to enhance equity and promote healthier maternal and infants’ pregnancy outcomes within diverse communities.