The following is a summary of “Group vs. traditional prenatal care for improving racial equity in preterm birth and low birthweight: the Centering and Racial Disparities randomized clinical trial study,” published in the December 2022 issue of Obstetrics and Gynocology by Crockett, et al.

Preterm birth and low birthweight rates are chronically high in the United States, and there are large racial inequalities in these rates. Innovative group prenatal care models, like CenteringPregnancy, have been suggested as a viable strategy to lower gaps in these pregnancy outcomes and improve the incidence of preterm delivery and low birth weight. For a study, researchers sought to determine if group prenatal care would lower rates of preterm delivery and low birthweight compared to individual prenatal care and whether it would lower the racial discrepancy in these rates between Black and White patients.

The study was conducted at a single study location with medically low-risk pregnant participants. Prenatal treatment was randomly assigned 1:1 to eligible patients in groups of one or one and one, according to their self-declared race and ethnicity. The two main results were low birthweight (less than <2,500 g) and preterm birth (<37 weeks of gestation). According to the intent-to-treat principle, the primary analysis was completed. Modified intent-to-treat and per-compliance techniques were used in the secondary analyses in accordance with the as-treated concept. Planning included analyzing how race and ethnicity affected impact modification.

There were 2,350 individuals altogether, 1,176 of whom were given prenatal care in groups, and 1,174 of whom were given prenatal care in solitude. 952 Black people (40.5%), 502 Hispanic people (21.4%), 863 White people (36.8%), and 31 people who identified as “other races or ethnicities” (1.3%) made up the study’s participant population. Preterm birth rates (10.4% vs. 8.7%; odds ratio, 1.22; 95% CI, 0.92-1.63; P=.17) and low birthweight rates (9.6% vs. 8.9%; odds ratio, 1.08; 95% CI, 0.80-1.45; P=.62) were not lower with group prenatal care than with individual prenatal care. Less preterm birth and low birthweight were shown to be more common in subgroup analyses when there was more prenatal care attendance. Intention to treat (51/409 [12.5%], modified intent to treat (36/313 [11.5%], and per compliance (20/240 [8.3%]) rates of low birthweight among Black group care participants were the ones where this impact was most pronounced. Although Black participants had significantly higher rates of low birthweight than White participants in individual care (adjusted odds ratio, 2.00; 95% CI, 1.14-3.50), the difference was not statistically significant when comparing Black participants to their White counterparts in group care (adjusted odds ratio, 1.58; 95% CI, 0.74-3.34).

Prenatal care provided in groups and individually had similar overall rates of preterm delivery and low birth weight. Black individuals’ rates of preterm delivery and low birthweight were shown to be decreased with increasing group prenatal care involvement. It was important to continue researching how group care models might help to lessen racial inequalities in birth outcomes.

Reference: ajog.org/article/S0002-9378(22)00734-7/fulltext