Online Program

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

Tuesday, November 3, 2015 : 4:30 p.m. - 4:45 p.m.

Sarah Gareau, DrPH, MEd, MCHES, Division of Policy and Research on Medicaid and Medicare, University of South Carolina, Institute for Families in Society, Columbia, SC
Ana Lopez Defede, Ph.D., Department of Family and Preventive Medicine/SOM, Institute for Families in Society, Columbia, SC
Tammy Cummings, Ph.D., University of South Carolina, University of South Carolina, Columbia, SC
Elizabeth Crouch, Ph.D., Institute for Familes in Society, University of South Carolina, Columbia, SC

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.


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.


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).


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.

Learning Areas:

Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health administration or related administration

Learning Objectives:
Differentiate between group prenatal care and traditional individual prenatal care Discuss the impact that 5 or more visits of group prenatal care may have on improving birth outcomes Evaluate methods used to assess prenatal care dosing

Keyword(s): Prenatal Care, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I earned my doctorate of public health with a focus on women's health policy in 2010 and have been involved in women's health initiatives for over fifteen years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.