Number of visits matter: An exploration of dosing in group prenatal care

Background:

The health benefits of group prenatal care have been established, but no study has explored dosing.  This study explored whether five or more visits in the Centering Pregnancy group prenatal care (CPG) program was associated with improved birth outcomes.

Methods:

A retrospective cohort study was used to test for differences in outcomes among Medicaid women participating in CPG (n=1,263) and those receiving individual prenatal care (n=6,582). Study outcomes included premature birth, low birth weight, and neonatal intensive care visits. To determine whether participants who attended five or more visits had better outcomes than those who attended four or fewer visits, generalized linear models with a binomial distribution and log link function estimated relative risk ratios.

Results:

For women who attended five or more CPG prenatal care visits, the relative risk of a mother having a premature delivery is reduced by 50% (RR=0.50). CPG prenatal care attendance of five or more visits reduced the risk of a having a low birth weight infant by 50% (RR=0.50) and NICU following delivery by 55% (RR=0.45).

Conclusions:

This study is the first national  examination of “dosing” for CPG  prenatal care. The findings have policy implications for maternal and child health recommendations, as well as reimbursement rates.  Incentivizing health care providers to embrace group prenatal care at the appropriate dosing level results in better health outcomes.  From a public health perspective, reimbursement and incentive policies that decrease barriers and increase the number of prenatal care visits are desirable.