The Impact of Group Prenatal Care on Interpregnancy Interval.
The Impact of Group Prenatal Care on Interpregnancy Interval.
复制标题
团体产前护理对妊娠间隔的影响。
DOI：
10.1055/s-0041-1739413
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发表时间：
2023
影响因子：
2
通讯作者：
Carter,EbonyB
中科院分区：
文献类型：
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作者：
Keller,JustineM;Norton,JessicaA;Zhang,Fan;Paul,Rachel;Madden,Tessa;Raghuraman,Nandini;Stout,MollyJ;Carter,EbonyB
目的评价参加CenteringPregnancy组产前护理是否与解释间隔（IPI）≤6个月的风险降低相关。研究设计我们对2007年至2014年参加密苏里州医疗补助的妇女进行了一项回顾性队列研究，使用与婴儿出生证明记录相关的母亲医疗补助数据。入选标准为≥11岁的女性，研究期间≥1次存活的单胎分娩，居住在圣路易斯市或县，≥2次产前访视。主要结局为IPI ≤6个月。次要结局包括IPI ≤12个月、IPI ≤18个月、产后长效可逆避孕（LARC）摄取和产后LARC贮库型醋酸甲羟孕酮（DMPA）摄取。资料以描述性统计及逻辑回归分析。采用后向逐步Logistic回归调整潜在的混杂因素，包括产妇年龄，种族，肥胖，未产妇，婚姻状况，糖尿病，高血压，早产前，和产妇教育。ResultsOf 54,968怀孕符合纳入标准，1,550（3%）参加CenteringPregnancy。CenteringPregnancy受试者IPI ≤6个月的可能性较低（校正比值比[aOR]：0.61; 95%置信区间[CI]：0.47-0.79），IPI ≤12个月的可能性较低（aOR：0.74; 95% CI：0.62-0.87）。然而，IPI ≤18个月的患者无差异（aOR：0.89; 95% CI：0.77-1.13）。CenteringPregnancy的妇女更有可能使用LARC进行产后避孕（aOR：1.37; 95%CI：1.20-1.57）. ConclusionCenteringPregnancy的参与与参加密苏里州医疗补助计划的妇女中IPI ≤6和≤12个月的显著降低以及产后LARC摄取的显著增加相关。
ObjectiveTo evaluate whether participation in CenteringPregnancy group prenatal care is associated with decreased risk of an interpregnancy interval (IPI) ≤6 months.Study DesignWe conducted a retrospective cohort study of women enrolled in Missouri Medicaid from 2007 to 2014 using maternal Medicaid data linked to infant birth certificate records. Inclusion criteria were women ≥11 years old, ≥1 viable singleton delivery during the study period, residency in St. Louis city or county, and ≥2 prenatal visits. The primary outcome was an IPI ≤6 months. Secondary outcomes included IPI ≤12 months, IPI ≤18 months, postpartum long-acting reversible contraception (LARC) uptake, and postpartum LARCordepot medroxyprogesterone acetate (DMPA) uptake. Data were analyzed using descriptive statistics and logistic regression. Backward stepwise logistic regression was used to adjust for potential confounders including maternal age, race, obesity, nulliparity, marital status, diabetes, hypertension, prior preterm birth, and maternal education.ResultsOf the 54,968 pregnancies meeting inclusion criteria, 1,550 (3%) participated in CenteringPregnancy. CenteringPregnancy participants were less likely to have an IPI ≤6 months (adjusted odds ratio [aOR]: 0.61; 95% confidence interval [CI]: 0.47–0.79) and an IPI ≤12 months (aOR: 0.74; 95% CI: 0.62–0.87). However, there was no difference for an IPI ≤18 months (aOR: 0.89; 95% CI: 0.77–1.13). Women in CenteringPregnancy were more likely to use LARC for postpartum contraception (aOR: 1.37; 95% CI: 1.20–1.57).ConclusionParticipation in CenteringPregnancy is associated with a significant decrease in an IPI ≤6 and ≤12 months and a significant increase in postpartum LARC uptake among women enrolled in Missouri Medicaid compared with women in traditional prenatal care.Key Points