The Effect of CenteringPregnancy Group Antenatal Care on Maternal, Birth, and Neonatal Outcomes Among Low‐Risk Women in the Netherlands: A Stepped‐Wedge Cluster Randomized Trial

作者：Mary‐ann Wagijo, Mathilde R. Crone, Birgit Bruinsma‐van Zwicht, Jan van Lith, Deborah L. Billings, Marlies Rijnders · 发表于：Journal of Midwifery & Women s Health · 年份：2024 · DOI：10.1111/jmwh.13582 · 被引用次数：15 · 研究领域：Breastfeeding Practices and Influences、Maternal and Neonatal Healthcare、Gestational Diabetes Research and Management

INTRODUCTION: This study was carried out to assess the effects of participating in CenteringPregnancy (CP) on maternal, birth, and neonatal outcomes among low-risk pregnant women in the Netherlands. METHODS: A total of 2124 pregnant women in primary care were included in the study. Data were derived from the Dutch national database, Perined, complemented with data from questionnaires completed by pregnant women. A stepwise-wedge design was employed; multilevel intention-to-treat analyses and propensity score matching were the main analytic approaches. Propensity score matching resulted in sample sizes of 305 nulliparous women in both the individual care (IC) and the matched control group (control-IC) and 267 in the CP and control-CP groups. For multiparous women, 354 matches were found for IC and control-IC groups and 152 for CP and control-CP groups. Main outcome measures were maternal, birth, and neonatal outcomes. RESULTS: Compared with the control-CP group receiving standard antenatal care, nulliparous women participating in CP had a lower risk of maternal hypertensive disorders (odds ratio [OR], 0.53; 95% CI, 0.30-0.93) and for the composite adverse maternal outcome (OR, 0.52; 95% CI, 0.33-0.82). Breastfeeding initiation rates were higher amongst nulliparous (OR, 2.23; 95% CI, 134-3.69) and multiparous women (OR, 1.62; 95% CI, 1.00-2.62) participating in CP compared with women in the control-CP group. CONCLUSION: Nulliparous women in CP were at lower risk of developing h...