Poster - Centering Improves Birth Outcomes in Puerto Rico
Mar 19, 2016 6:36:37 GMT -5
Tanya Munroe and Lucinda Colon like this
Post by John Craine on Mar 19, 2016 6:36:37 GMT -5
University of Puerto Rico implemented CenteringPregnancy in 2013 as part of the Centers for Medicare and Medicaid Services (CMS) Strong Start for Mothers and Newborns Initiative.
Objectives: In order to improve infant outcomes and reduce the rate of preterm birth (PTB) we implemented an innovative model of group prenatal care (Centering Pregnancy) that utilizes a facilitative leadership style and principles of adult education. It has three components: assessment, education, and support. This model has been demonstrated to reduce PTB. Women were enrolled into Group Prenatal Care (Transformación Prenatal) if they were receiving care funded by the Mi Salud, and had at least one risk for PTB according to known risk factors for low birth weight or PTB. This report compares the outcomes of the infants born of women in group vs. traditional care.
Methods: Mother’s age, parity, risk factors, prenatal/delivery complications, infants’ gestational age (GA), birth weight, Apgar scores, delivery route, indications for delivery, and use of neonatal intensive care unit (NICU) were abstracted from charts of mothers who received group or traditional care at the University Hospital, San Juan, PR.
Results: The mean birth weight and gestational age of the infants from Group care were higher (6.6 vs. 6.3 lbs. and 37.8 vs. 36.8 weeks) than for those in Traditional care. Lower rates of preterm birth were demonstrated for Group prenatal care (28% vs. 34%). Consequently, more infants were born at term if the mothers received Group care. All were statistically significant (P<.05).
Conclusions: We successfully implemented Group prenatal care for the first time in PR in a complex environment: tertiary care hospital with a high risk prenatal clinic. In spite of having known risk factors for preterm birth, the mothers in Group care had better outcomes. In an environment of adverse determinants of health, the program was effective in reducing the odds for bad outcomes early in life and demonstrating that innovative models of health care can improve outcomes.
Objectives: In order to improve infant outcomes and reduce the rate of preterm birth (PTB) we implemented an innovative model of group prenatal care (Centering Pregnancy) that utilizes a facilitative leadership style and principles of adult education. It has three components: assessment, education, and support. This model has been demonstrated to reduce PTB. Women were enrolled into Group Prenatal Care (Transformación Prenatal) if they were receiving care funded by the Mi Salud, and had at least one risk for PTB according to known risk factors for low birth weight or PTB. This report compares the outcomes of the infants born of women in group vs. traditional care.
Methods: Mother’s age, parity, risk factors, prenatal/delivery complications, infants’ gestational age (GA), birth weight, Apgar scores, delivery route, indications for delivery, and use of neonatal intensive care unit (NICU) were abstracted from charts of mothers who received group or traditional care at the University Hospital, San Juan, PR.
Results: The mean birth weight and gestational age of the infants from Group care were higher (6.6 vs. 6.3 lbs. and 37.8 vs. 36.8 weeks) than for those in Traditional care. Lower rates of preterm birth were demonstrated for Group prenatal care (28% vs. 34%). Consequently, more infants were born at term if the mothers received Group care. All were statistically significant (P<.05).
Conclusions: We successfully implemented Group prenatal care for the first time in PR in a complex environment: tertiary care hospital with a high risk prenatal clinic. In spite of having known risk factors for preterm birth, the mothers in Group care had better outcomes. In an environment of adverse determinants of health, the program was effective in reducing the odds for bad outcomes early in life and demonstrating that innovative models of health care can improve outcomes.