Top

Published in:

01-04-2016 | Original Article

The comparative effects of group prenatal care on psychosocial outcomes

Authors: Emily C. Heberlein, Amy H. Picklesimer, Deborah L. Billings, Sarah Covington-Kolb, Naomi Farber, Edward A. Frongillo

Published in: Archives of Women's Mental Health | Issue 2/2016

Abstract

To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89 % completing the second survey (mean gestational age 32.7 weeks) and 84 % completing the third survey (6 weeks’ postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p < 0.05) in their use of prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p < 0.01) in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group prenatal care for all women.

Alexander GR, Kotelchuck M (2001) Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research. Public Health Rep 116:306–316CrossRefPubMedPubMedCentral

American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2012) Guidelines for perinatal care, 7th edn. American Academy of Pediatrics, Elk Grove Village

Baldwin KA (2006) Comparison of selected outcomes of CenteringPregnancy versus traditional prenatal care. J Midwifery Womens Health 51:266–272CrossRefPubMed

Barkin JL, Wisner KL, Bromberger JT, Beach SR, Terry MA, Wisniewski SR (2010a) Development of the Barkin index of maternal functioning. J Womens Health 19:2239–2246CrossRef

Barkin JL, Wisner KL, Bromberger JT, Beach SR, Wisniewski SR (2010b) Assessment of functioning in new mothers. J Womens Health 19:1493–1499CrossRef

Barkin JL, Wisner KL, Wisniewski SR (2014) The psychometric properties of the Barkin index of maternal functioning. J Obstet Gynecol Neonatal Nurs 43:792–802CrossRefPubMed

Behrman RE, Butler AS (2007) Preterm birth: causes, consequences, and prevention. Natl Academy Pr, Washington, DC

Borders AEB, Grobman WA, Amsden LB, Holl JL (2007) Chronic stress and low birth weight neonates in a low-income population of women. Obstet Gynecol 109:331–338CrossRefPubMed

Carver CS, Scheier MF, Segerstrom SC (2010) Optimism. Clin Psychol Rev 30:879–889CrossRefPubMedPubMedCentral

Cohen S, Janicki-Deverts D (2012) Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006 and 2009. J Appl Soc Psychol 42:1320–1334. doi:10.1111/j.1559-1816.2012.00900.x CrossRef

Cohen S, Williamson G (1988) Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S (eds) The social psychology of health: Claremont symposium on applied social psychology. Sage, Newbury Park, pp 31–67

Condon JT, Corkindale CJ (1998) The assessment of parent-to-infant attachment: development of a self-report questionnaire instrument. J Reprod Infant Psychol 16:57–76CrossRef

Davalos D, Yadon C, Tregellas H (2012) Untreated prenatal maternal depression and the potential risks to offspring: a review. Arch Womens Ment Health 15:1–14. doi:10.1007/s00737-011-0251-1 CrossRefPubMed

de Castro F, Place JMS, Billings DL, Rivera L, Frongillo EA (2015) Risk profiles associated with postnatal depressive symptoms among women in a public sector hospital in Mexico: the role of sociodemographic and psychosocial factors. Arch Womens Ment Health 18:163–471. doi:10.1007/s00737-014-0472-1

DeLongis A, Holtzman S (2005) Coping in context: the role of stress, social support, and personality in coping. J Pers 73:1633–1656CrossRefPubMed

Dole N, Savitz DA, Siega-Riz AM, Hertz-Picciotto I, McMahon MJ, Buekens P (2004) Psychosocial factors and preterm birth among African American and white women in central North Carolina. Am J Public Health 94:1358–1365. doi:10.2105/ajph.94.8.1358 CrossRefPubMedPubMedCentral

Dunkel Schetter C (2011) Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol 62:531–558. doi:10.1146/annurev.psych.031809.130727 CrossRefPubMed

Dunkel-Schetter C, Glynn LM (2010) Stress in pregnancy: empirical evidence and theoretical issues to guide interdisciplinary research. In: Contrada RJ, Baum A (eds) The handbook of stress science: Biology, psychology and health. Springer, New York

Emmanuel E, St John W (2010) Maternal distress: a concept analysis. J Adv Nurs 66:2104–2115. doi:10.1111/j.1365-2648.2010.05371.x PubMed

Fitzmaurice GM, Laird NM, Ware JH (2004) Applied longitudinal analysis. John Wiley & Sons, Hoboken

Folkman S, Moskowitz JT (2000) Positive affect and the other side of coping. Am Psychol 55:647–654CrossRefPubMed

Folkman S, Moskowitz JT (2004) Coping: pitfalls and promise. Annu Rev Psychol 55:745–774CrossRefPubMed

Glover V (2014) Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol 28:25–35CrossRefPubMed

Hale N, Picklesimer AH, Billings DL, Covington-Kolb S (2014) The impact of CenteringPregnancy group prenatal care on postpartum family planning. Am J Obstet Gynecol 210:50.e51–50.e57. doi:10.1016/j.ajog.2013.09.001 CrossRef

Hamilton JG, Lobel M (2008) Types, patterns, and predictors of coping with stress during pregnancy: examination of the revised prenatal coping inventory in a diverse sample. J Psychosom Obstet Gynaecol 29:97–104. doi:10.1080/01674820701690624 CrossRefPubMed

Heron J, O'Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73. doi:10.1016/j.jad.2003.08.004 CrossRefPubMed

Ickovics JR, Kershaw TS, Westdahl C, Rising SS, Klima C, Reynolds H, Magriples U (2003) Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics. Obstet Gynecol 102:1051–1057PubMed

Ickovics JR, Kershaw TS, Westdahl C, Magriples U, Massey Z, Reynolds H, Rising SS (2007) Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol 110:330–339CrossRefPubMedPubMedCentral

Ickovics JR, Reed E, Magriples U, Westdahl C, Schindler Rising S, Kershaw TS (2011) Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial. Psychol Health 26:235–250. doi:10.1080/08870446.2011.531577 CrossRefPubMedPubMedCentral

Kennedy HP, Farrell T, Paden R, Hill S, Jolivet RR, Cooper BA, Schindler Rising S (2011) A randomized clinical trial of group prenatal care in two military settings. Mil Med 176:1169–1177CrossRefPubMed

Klima C (2005) Pregnancy related empowerment scale. University of Illinois—Chicago College of Nursing, Chicago

Kramer MS et al (2009) Stress pathways to spontaneous preterm birth: the role of stressors, psychological distress, and stress hormones. Am J Epidemiol 169:1319–1326CrossRefPubMed

Krans EE, Davis MM (2012) Preventing low birthweight: 25 years, prenatal risk, and the failure to reinvent prenatal care. Am J Obstet Gynecol 206:398–403. doi:10.1016/j.ajog.2011.06.082 CrossRefPubMed

Lazarus RS, Folkman S (1984) Stress, appraisal, and coping. Springer Publishing Company, New York

Lazinski M, Shea A, Steiner M (2008) Effects of maternal prenatal stress on offspring development: a commentary. Arch Womens Ment Health 11:363–375. doi:10.1007/s00737-008-0035-4 CrossRefPubMed

Lobel M (1996) The revised prenatal distress questionnaire (NUPDQ). Stony Brook University, Stony Brook

Lobel M, Cannella DL, Graham JE, DeVincent C, Schneider J, Meyer BA (2008) Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychol 27:604–615. doi:10.1037/a0013242 CrossRefPubMed

Manant A, Dodgson JE (2011) CenteringPregnancy: an integrative literature review. J Midwifery Womens Health 56:94–102. doi:10.1111/j.1542-2011.2010.00021.x CrossRefPubMed

Martin JA, Hamilton BE, Osterman MJK, Curtin SC, Matthews MS (2013) Births: final data for 2012 vol 62. National Center for Health Statistics, Hyattsville

Mason Z, Briggs R, Silver E (2011) Maternal attachment feelings mediate between maternal reports of depression, infant social–emotional development, and parenting stress. J Reprod Infant Psychol 29:382–394. doi:10.1080/02646838.2011.629994 CrossRef

Massey Z, Rising SS, Ickovics J (2006) CenteringPregnancy group prenatal care: promoting relationship‐centered care. J Obstet Gynecol Neonatal Nurs 35:286–294CrossRefPubMed

McDonald SW, Kingston D, Bayrampour H, Dolan SM, Tough SC (2014) Cumulative psychosocial stress, coping resources, and preterm birth. Arch Womens Ment Health 17:559–568CrossRefPubMed

National Research Council and Institute of Medicine (2009) Depression in parents, parenting, and children: opportunities to improve identification, treatment, and prevention. The National Academies Press, Washington, DC

Novick G (2009) Women's experience of prenatal care: an integrative review. J Midwifery Womens Health 54:226–237. doi:10.1016/j.jmwh.2009.02.003 CrossRefPubMedPubMedCentral

Picklesimer AH, Billings D, Hale N, Blackhurst D, Covington-Kolb S (2012) The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. Am J Obstet Gynecol 206:415.e411–415.e417. doi:10.1016/j.ajog.2012.01.040

Radloff LS (1977) The CES-D scale. Appl Psychol Meas 1:385–401CrossRef

Rising SS, Kennedy HP, Klima CS (2004) Redesigning prenatal care through CenteringPregnancy. J Midwifery Womens Health 49:398–404CrossRefPubMed

Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295. doi:10.1016/j.genhosppsych.2004.02.006 CrossRefPubMed

Robertson B, Aycock DM, Darnell LA (2009) Comparison of CenteringPregnancy to traditional care in Hispanic mothers. Matern Child Health J 13:407–414. doi:10.1007/s10995-008-0353-1 CrossRefPubMed

Scheier MF, Carver CS, Bridges MW (1994) Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the life orientation test. J Pers Soc Psychol 67:1063–1078. doi:10.1037/0022-3514.67.6.1063 CrossRefPubMed

Sheeder J, Weber Yorga K, Kabir-Greher K (2012) A review of prenatal group care literature: the need for a structured theoretical framework and systematic evaluation. Matern Child Health J 16:177–187. doi:10.1007/s10995-010-0709-1 CrossRefPubMed

StataCorp LP (2011) Stata 12. StataCorp, College Station

Tandon SD, Colon L, Vega P, Murphy J, Alonso A (2012) Birth outcomes associated with receipt of group prenatal care among low‐income Hispanic women. J Midwifery Womens Health 57:476–481. doi:10.1111/j.1542-2011.2012.00184.x CrossRefPubMed

Tanner-Smith E, Steinka-Fry K, Lipsey M (2013a) Effects of CenteringPregnancy group prenatal care on breastfeeding outcomes. J Midwifery Womens Health 58:389–395CrossRefPubMed

Tanner-Smith EE, Steinka-Fry KT, Lipsey MW (2013b) The effects of CenteringPregnancy group prenatal care on gestational age, birth weight, and fetal demise. Matern Child Health J 18:801–809. doi:10.1007/s10995-013-1304-z CrossRef

Tanner-Smith EE, Steinka-Fry KT, Gesell SB (2014) Comparative effectiveness of group and individual prenatal care on gestational weight gain. Matern Child Health J 18:1711–1720. doi:10.1007/s10995-013-1413-8 CrossRefPubMedPubMedCentral

Urizar GG Jr, Milazzo M, Le HN, Delucchi K, Sotelo R, Muñoz RF (2004) Impact of stress reduction instructions on stress and cortisol levels during pregnancy. Biol Psychol 67:275–282. doi:10.1016/j.biopsycho.2003.11.001 CrossRefPubMed

Vieten C, Astin J (2008) Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 11:67–74. doi:10.1007/s00737-008-0214-3 CrossRefPubMed

Wakeel F, Wisk LE, Gee R, Chao SM, Witt WP (2013) The balance between stress and personal capital during pregnancy and the relationship with adverse obstetric outcomes: findings from the 2007 Los Angeles mommy and baby (LAMB) study. Arch Womens Ment Health 16:435–451. doi:10.1007/s00737-013-0367-6 CrossRefPubMed

Walford HH, Trinh S, Wiencrot A, Lu MC (2011) What is the role of prenatal care in reducing racial and ethnic disparities in pregnancy outcomes? In: Handler A, Kennelly J, Peacock N (eds) Reducing racial/ethnic disparities in reproductive and perinatal outcomes. Springer, New York, pp 151–179CrossRef

Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070CrossRefPubMed

Webster J, Linnane JWJ, Dibley LM, Hinson JK, Starrenburg SE, Roberts JA (2000) Measuring social support in pregnancy: can it be simple and meaningful? Birth 27:97–101CrossRefPubMed

Webster J, Nicholas C, Velacott C, Cridland N, Fawcett L (2011) Quality of life and depression following childbirth: impact of social support. Midwifery 27:745–749. doi:10.1016/j.midw.2010.05.014 CrossRefPubMed

Witt WP, Litzelman K, Cheng ER, Wakeel F, Barker ES (2014) Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes. Matern Child Health J 18:52–63CrossRefPubMed

Title: The comparative effects of group prenatal care on psychosocial outcomes
Authors: Emily C. Heberlein
Amy H. Picklesimer
Deborah L. Billings
Sarah Covington-Kolb
Naomi Farber
Edward A. Frongillo
Publication date: 01-04-2016
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 2/2016
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-015-0564-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The comparative effects of group prenatal care on psychosocial outcomes

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2016

Postpartum depression among visible and invisible sexual minority women: a pilot study

Infant sleep and feeding patterns are associated with maternal sleep, stress, and depressed mood in women with a history of major depressive disorder (MDD)

Suicidality among pregnant women in Brazil: prevalence and risk factors

Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study

PREPP: postpartum depression prevention through the mother–infant dyad

Estimated prevalence of antenatal depression in the US population