Impact of CenteringPregnancy
Mentor 1
Teresa S. Johnson
Location
Union Wisconsin Room
Start Date
5-4-2019 1:30 PM
End Date
5-4-2019 3:30 PM
Description
Wisconsin has one of the highest infant mortality rates for Black infants. Racine, an urban community located within Wisconsin had the highest statewide Black infant mortality rates, at 3x higher than the national average. To address this disparity, many community-wide programs were implemented to decrease the rate of prematurity, a leading cause of infant mortality. Breastfeeding and care delivery interventions were also implemented to decrease infant mortality. CenteringPregnancy (CP) is a model of group prenatal care where women are provided with prenatal care in groups of women with similar due dates. In this clinical setting, women must “opt out” of CP if they do not want to participate in group prenatal care. The ongoing evaluation of pregnancy, birth, and infant outcomes is conducted through written evaluations as well as perinatal data that is entered into Peridata.net, a large data base that allows us to monitor and report outcomes. The outcomes are reviewed from 1/1/2013-12/31/2017 (1st 5 years of program data). When CP outcomes were first presented in 2016 with fewer years of data, breastfeeding initiation increased to 89.5% and prematurity was at 4% (less than the national level of 12%). The results this time were very different. First there were significantly higher percentages of stillbirths (1.5 vs. 0.8%), preterm infants (30.1 vs. 22.4 %), and NICU admissions (17.4 vs. 13.2%), and lower percentages of breastfeeding (50.3 vs 73.4%) among women who participated in CP. While this might seem counter-intuitive, a higher percentage of African-American women, who have a higher risk for fetal and infant mortality are participating in CP at > 30%, which is higher percentage of African-American women than receive prenatal care at this institution (19-25%). Sound decisions about appropriateness of this model for specific populations must rest on well-formulated and rigorously conducted research.
Impact of CenteringPregnancy
Union Wisconsin Room
Wisconsin has one of the highest infant mortality rates for Black infants. Racine, an urban community located within Wisconsin had the highest statewide Black infant mortality rates, at 3x higher than the national average. To address this disparity, many community-wide programs were implemented to decrease the rate of prematurity, a leading cause of infant mortality. Breastfeeding and care delivery interventions were also implemented to decrease infant mortality. CenteringPregnancy (CP) is a model of group prenatal care where women are provided with prenatal care in groups of women with similar due dates. In this clinical setting, women must “opt out” of CP if they do not want to participate in group prenatal care. The ongoing evaluation of pregnancy, birth, and infant outcomes is conducted through written evaluations as well as perinatal data that is entered into Peridata.net, a large data base that allows us to monitor and report outcomes. The outcomes are reviewed from 1/1/2013-12/31/2017 (1st 5 years of program data). When CP outcomes were first presented in 2016 with fewer years of data, breastfeeding initiation increased to 89.5% and prematurity was at 4% (less than the national level of 12%). The results this time were very different. First there were significantly higher percentages of stillbirths (1.5 vs. 0.8%), preterm infants (30.1 vs. 22.4 %), and NICU admissions (17.4 vs. 13.2%), and lower percentages of breastfeeding (50.3 vs 73.4%) among women who participated in CP. While this might seem counter-intuitive, a higher percentage of African-American women, who have a higher risk for fetal and infant mortality are participating in CP at > 30%, which is higher percentage of African-American women than receive prenatal care at this institution (19-25%). Sound decisions about appropriateness of this model for specific populations must rest on well-formulated and rigorously conducted research.
