Table 1 Characteristic of studies comparing gestational weight gain in group and traditional prenatal care settings
From: Gestational weight gain and group prenatal care: a systematic review and meta-analysis
Author Publication Year | Study Design Study Years | Country/Setting | Inclusion/Exclusion for Group Care at the site | Inclusion/Exclusion for the study of group care at the site | Participant demographics | BMI, GWG, and GWG goal definitions | Prenatal care model |
|---|---|---|---|---|---|---|---|
Randomized Controlled Trials | |||||||
Kennedy 2011 [29] | RCT 2005–2007 | US Military Naval Hospital in Pacific Northwest | < 16 weeks, ≥18 years, no severe medical problems, understand English | < 16 weeks, ≥18 years, no severe medical problems, understand English | 58–60% white Mean age 25 years 45–59% nulliparas Mean BMI range 26.0–26.4 kg/m2at study baseline | BMI: not stated GWG: difference between time 1 (12–16 weeks) and delivery GWG goals: not stated | CP |
Harden 2014 [22] | Feasibility pilot study with “random assignment” Years not stated | Country not stated Low-income families | Pre-pregnancy BMI ≥ 30 kg/m2, attended clinic that served low-income families, physician clearance, 21–35 years, < 21 weeks, no medical contraindication to physical activity, English speaking | Pre-pregnancy BMI ≥ 30 kg/m2, attended clinic that served low-income families, physician clearance, 21–35 years, < 21 weeks, no medical contraindication to physical activity, English speaking | 61.5% Caucasian Mean age 22 years 100% obese with mean BMI 37.64 kg/m2 | BMI: pre-pregnancy weight GWG: week 4,8,12,16,20 of intervention minus beginning of intervention GWG goals: 2009 IOM | Prenatal group visits in group-based lifestyle sessions |
Magriples 2015 [25] | Secondary analysis from RCT 2008–2012 | US 14 Community Health Centers and hospitals in New York City, New York serving low-income minorities | 14–21 years, < 24 weeks, no severe medical problems, English or Spanish speaking | Excluded: multiple births, history of heart disease, CHTN, DM, no BMI data, missing or invalid weight data | 63.5% Latina Mean age 19 years 85% nulliparas 12% underweight 53% normal 20% overweight 16% obese | BMI: self-reported pre-pregnancy weight GWG: not stated GWG goals: 2009 IOM | CP Plus (Structured reproductive health promotion activities during 4 of the 10 sessions including activities to improve sexual self-efficacy, HIV knowledge, interpersonal sexual communication, perceived risk, and social norms) |
Cohort studies | |||||||
Klima 2009 [26] | Retrospective cohort 2004–2006 | US Low-income Chicago, Illinois public health clinic, all women eligible for Medicaid | Continuing care at site, < 18 weeks, no high risk obstetric conditions | Exclusions: fetal demise < 28 weeks, delivered before attending 4 group or individual visits, delivery at other hospital | 100% African-American Mean age range 20.8–22.1 years | BMI: not stated GWG: not stated GWG goals: not stated | CP |
Holbrook 2010 [31] | Pilot chart review 2009 | US Northern California | Not stated | Spanish-speaking | 100% Hispanic | BMI: not stated GWG: first recorded weight to last recorded weight GWG goals: excessive defined as > 1 pound/week in the 3rd trimester | CP |
Trudnak 2013 [27] | Retrospective cohort 2006–2010 | US Southern Florida public health clinic | Spanish-speaking, Hispanic ethnicity | Initial visit completed before 4 months gestation, completed at least 50% of visits | > 90% Hispanic Mean age range 25–26.0 years 33–54% nulliparas 2% underweight 50% normal weight 33% overweight 13% obese 1% morbid obese | BMI: pre-pregnancy weight GWG: weight at last prenatal visit minus pre-pregnancy weight GWG goals: 2009 IOM | CP |
Tanner-Smith 2014 [35] | Retrospective cohort 2008–2011 | US Faith-based community health center in Southern metropolitan area | English speaking, no high risk conditions (prior CD, prior LBW, DM, SLE, heart disease, clotting problems, seizures, kidney disorder, cervical incompetence, mental health disorder) | Not stated | 76% non-Hispanic black, 13% Latina, 11% White 88% public insurance Mean age 22 years Median gravidity 2 43% healthy weight 30% overweight 27% obese | BMI: pre-pregnancy weight GWG: last prenatal visit minus 1st prenatal visit GWG goals: IOM 2009 based on pre-pregnancy weight | CP |
Zielinski 2014 [34] | Case-control retrospective 2010–2012 | US CNM hospital-based practice in southwest Michigan | < 20 weeks, eligible for CNM care | < 20 weeks, eligible for CNM care | Mean age range 24–25 years 49% private insurance 78% white 4% underweight 41–42% normal 29–30% overweight 25% obese | BMI: self-reported pre-pregnancy weight GWG: not stated GWG goals: 2009 IOM | CP |
Walton 2015 [28] | Retrospective cohort 2009–2013 | US Military Naval Medical Center in San Diego, California in a tertiary care teaching hospital with outpatient clinics | Not stated | Included: Delivery at Naval Medical Center in San Diego, > 20 weeks at delivery Excluded: “late to care”, transfer of care, dependent daughters of active duty members | 48% Caucasian Mean age range 25–26 years 57–75% nulliparas Mean range of pre-pregnancy BMI 24.3–25.0 kg/m2 | BMI: pre-pregnancy weight GWG: not stated GWG goals: 2009 IOM | CP |
Trotman 2015 [24] | Retrospective cohort 2008–2012 | US MedStar Health Research Institute Washington, D.C. in a teaching urban hospital with adolescents | Not stated | 11–21 years, No significant medical history or pregnancy complication requiring high risk care | 96% African-American Mean age 17 years 70% nulliparas | BMI: not stated GWG: not stated GWG goals: 2009 IOM | CP |
Mazzoni 2015 [23] | Prospective observational 2013–2014 | US Hospital based clinic in Denver, Colorado affiliated with integrated safety net healthcare system | GDM, English or Spanish speaking, singleton | ≥ 2 of the 4 group visits | Mean age 31 years 89% Hispanic Mean pre-pregnancy BMI range 30–33 kg/m2 5–6% CHTN | BMI: pre-pregnancy weight GWG: not stated GWG goals: not stated | Group care for GDM at 26–32 weeks with 4 sessions |
Brumley 2016 [36] | Retrospective cohort 2011–2013 | US University of South Florida, academic center | Excluded: pregestational DM, CHTN, uncontrolled psychiatric disorders, multiple gestations, other major medical problems, > 20 weeks | ≥ 3 group visits | 62–76% white 57–79% nulliparas 2.1% underweight 60% healthy weight 22.6% overweight 15.4% obese | BMI: initial weight or self-reported pre-pregnancy weight if 1st visit occurred after the 1st trimester GWG: weight at last visit minus weight at 1st visit GWG goals: IOM, year not stated | CP |
O’Donnell 2016 [32] | Retrospective cohort 2011–2014, abstract only | US University of California-San Francisco Medical Center, CA | Not stated | 18–45 years, singleton, no fetal anomalies, no chronic medical problems, 1st prenatal visit < 20 weeks, attended ≥5 prenatal visits | Mean age 33 years 51% white, 25% Asian Mean pre-pregnancy BMI 24 kg/m2 | BMI: self-reported pre-pregnancy weight GWG: weight at delivery minus self-reported pre-pregnancy weight GWG goals: 2009 IOM | CP |
Schellinger 2016 [30] | Retrospective cohort 2010–2015 | US Inner city county hospital in Indiana | GDM, English or Spanish speaking | ≥ 18 years, singleton, no major fetal anomalies | Mean age 31 years 100% Hispanic for group 7% CHTN | BMI: not stated GWG: not stated GWG goals: not stated | Adapted CP for GDM with 4 sessions after GDM diagnosis |
Kominiarek 2017 [33] | Retrospective cohort 2009–2015 | US Greenville Health System, South Carolina | Exclusion: high risk medical conditions, multiple gestations, pre-pregnancy BMI > 45 kg/m2, entry to prenatal care after 24 weeks. | Inclusion: Pre-pregnancy height and weight and final pregnancy weight available, eligible for Medicaid coverage at the time of delivery Exclusion: Fetal demise, delivery outside of Greenville Health System | Mean age 23–26 years 22–24% Hispanic Mean pre-pregnancy BMI 26 kg/m2 16–18% tobacco use | BMI: self-reported pre-pregnancy weight GWG: weight at delivery minus self-reported pre-pregnancy weight GWG goals: 2009 IOM | CP |