Table 3 Gestational weight gain outcomes for 15 studies
From: Gestational weight gain and group prenatal care: a systematic review and meta-analysis
Author, Year | Group PNC GWGa | Traditional PNC GWGa | p-value or OR (95% CI) | Selection of controls and analysis details | Preterm births | GA at delivery or preterm birth in GWG analysis | Total Number of PNC visits | Provider types |
|---|---|---|---|---|---|---|---|---|
Kennedy 2011 [29] | n = 162 33 pounds (mean) | n = 160 33.6 pounds (mean) | p = 0.71 | RCT | 7–10% | No correction for GA at delivery | 12.9% group vs. 46.9% < 9 visits, p < 0.001 | Physicians, midwives, and NP for both |
Harden 2014 [22] | n = 8 5.29 ± 5.33 kg | n = 8 8.64 ± 3.88 kg | p < 0.01 | “randomly assigned” | Not stated | No correction for GA at delivery | Not stated | Physicians for group |
Magriples 2015 [25] | n = 495 48.8% excessive | n = 489 51.6% excessive | p > 0.05e | Secondary RCT | Not stated | Multilevel modeling accounted for variability in timing of delivery | 9.3 group vs. 8.9, “not significant” | Physician or midwife for groups |
Klima 2009 [26] | n = 61 32.2 ± 13.6 pounds | n = 207 28.5 ± 15.6 pounds | p < 0.05 | All women who delivered at same hospital during study period | 11–13% | No correction for GA at delivery | 9.7 ± 2.7 group vs. 8.3 ± 3.4, p < 0.05 | CNM for both |
Holbrook 2010 [31] | n = 50 24 pounds (mean) | n = 50 28 pounds (mean) | “Not significant” | “convenience sample of the most recent 100 prenatal panel” | Not stated | No correction for GA at delivery | Not stated | Not stated |
Trudnak 2013 [27] | n = 247 15.5% below healthy 35.6% healthy 41.3% above healthy 2% missing | n = 240 33.4% below healthy 31.3% healthy 29.6% above healthy 3.8% missing | p < 0.01b aOR = 1.45 (0.79–2.62)c aOR = 0.41 (0.22–0.78)d | Matched for Hispanic ethnicity, primary language Spanish, month/year of prenatal care entry | 2.1–5.7% | No correction for GA at delivery | 91.9% group vs. 63.8% adequate APNCU index, p < 0.01 | Not stated |
Tanner-Smith 2014 [35] | n = 242 25.5 ± 13.99 pounds 30.2% low 33.5% healthy 36.4% excessive | n = 327 21.32 ± 14.50 pounds 44.0% low 29.4% healthy 26.6% excessive | Not statede | Propensity score matching for age, race, Spanish language speaker, education level, marital status, government insurance, current employment, gravidity, height, GA and weight at entry to care, pre-pregnancy BMI, systolic blood pressure, histories of non-gestational DM, depression, drug use, gynecological surgery, HTN, kidney problems, operations, blood transfusions, trauma | 8–16% | Accounted for GA at delivery with multiplicative interaction terms | 17.03 ± 5.83 group vs. 8.38 ± 4.13, no statistics in the unmatched sample | 1 CNM and 1 physician for group |
Zielinski 2014 [34] | n = 173 33.1 pounds (mean) 22% low 25% met 53% exceeded | n = 170 33.7 pounds (mean) 23% low 28% met 49% exceeded | p = 0.84 (mean) p = 0.24 (category) | Propensity score matching for age, insurance, race from n = 1427 women | 5.8–5.9% | No correction for GA at delivery | 14.2 ± 7.2 group vs. 13.4 ± 10.7, p = 0.27 | CNM for both |
Walton 2015 [28] | n = 202 14.9 ± 6.53 kg 52.7% excessive | N = 202 15.9 ± 6.53 kg 61.9% excessive | p = 0.11 (mean) p = 0.07 (category) | Selected from 2011 to 2013 | 5.5–6.9% | No correction for GA at delivery | “9 group visits” | CNM for both |
Trotman 2015 [24] | n = 50 2.0% met | n = 50 38.0% met single provider n = 50 38.0% met multiple provider | p = 0.02 (single provider) p = 0.02 (multiple provider) | Selected from either single or multiple provider according to age, time, and delivery criteria | 10–16% | No correction for GA at delivery | 62% group vs. 40.8–51.9% attended 100% of appointments | CNM or physicians for group |
Mazzoni 2015 [23] | n = 62 19.2 ± 13.0 pounds 3rd tri weight gain 6.7 ± 7.0 pounds | n = 103 18.0 ± 15.0 pounds 3rd tri weight gain 7.3 ± 6.6 pounds | p = 0.57 (total) p = 0.55 (3rd tri) | Women with GDM who delivered in 2012 at same hospital | 3–5% | No correction for GA at delivery | 12.4 ± 2.2 group vs. 14.0 ± 4.3 scheduled appointments, p = 0.002 | Obstetrician, CNM, psychologist, medical assistant for group; Obstetrician or MFM specialist for traditional |
Brumley 2016 [36] | n = 65 32.8 ± 10.7 pounds 33.8% met | n = 130 31.4 ± 12.7 pounds 36.2% met | p = 0.18 (mean) p = 0.24 (category) | Matched for age and pre-pregnancy BMI in 1:2 ratio | 1.5–6% | No correction for GA at delivery | Not stated | Midwives for group |
O’Donnell 2016 abstract only [32] | n = 125 46.4% excess | n = 2873 43.3% excess | p = 0.49 | Women who declined CP | Not stated | Not stated | Not stated | Not stated |
Schellinger 2016 [30] | n = 203 9.3 ± 4.5 kg | n = 257 10.2 ± 6.7 kg n = 120 (Hispanic women) 10.3 ± 5.7 kg | p = 0.21 (all women) p = 0.26 (Hispanic women) | Women who declined CP | 8–11% | No correction for GA at delivery | Not stated | Health educator, diabetic educator and physician for group |
Kominiarek 2017 [33] | n = 2117 30 pounds (18–18) median (IQR) 20% low 25% met 55% excessive | n = 4234 28 pounds (20–40) median (IQR) 26% low 26% met 48% excessive | p < 0.001 p < 0.001 (category) | Matched 1:2 with the next 2 women in traditional PNC who delivered with the same payer type, within 2 kg/m2 pre-pregnancy BMI units, and within 2 weeks of gestational age at delivery | 5–7% | Weekly rate of GWG calculated and then multiplied by 40 | 13.6 ± 3.2 group vs. 10.3 ± 3.9, p < 0.001 | NP or CNM for group |