375: Group prenatal care for women with pre-gestational type II diabetes mellitus: a cost-effectiveness analysis

Nguyen, Nancy; Allen, Allison; Gorman, Margaret; Hersh, Sally; Frias, Antonio E.; Cooper, Anne; Tilden, Ellen L.; Caughey, Aaron B.

doi:10.1016/j.ajog.2013.10.408

Cited by 6 publications

(3 citation statements)

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“…This was the only study found to include patients with pre-gestational diabetes. However, a decision-analytic model describing costs and pregnancy outcomes of women with type II diabetes mellitus attending GPC compared to traditional antenatal care demonstrated improved outcomes and cost-effectiveness of GPC “even when cost to attend group prenatal care was up to $11,000/pregnancy more than individual group care” [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic overview of the literature regarding group prenatal care for high-risk pregnant women

Byerley

Haas

2017

BMC Pregnancy Childbirth

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BackgroundGroup prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes. Our objective was to review and summarize outcomes for women in GPC for women with specific high-risk conditions.MethodsA systematic literature review of Ovid, PubMed, and Google Scholar was performed to identify studies reporting the effects of group prenatal care in high-risk populations. Studies were included if they reported on pregnancy outcome results for women using GPC. We also contacted providers known to be utilizing GPC for specific high-risk women. Descriptive results were compiled and summarized by high-risk population.ResultsWe identified 37 reports for inclusion (8 randomized trials, 23 nonrandomized studies, 6 reports of group outcomes without controls). Preterm birth was found to be decreased among low-income and African American women. Attendance at prenatal visits was shown to increase among women in GPC in the following groups: Opioid Addiction, Adolescents, and Low-Income. Improved weight trajectories and compliance with the IOM’s weight recommendations were found in adolescents. Increased rates of breastfeeding were found in adolescents and African Americans. Increased satisfaction with care was found in adolescents and African Americans. Pregnancy knowledge was increased among adolescents, as was uptake of LARC. Improved psychological outcomes were found among adolescents and low-income women. Studies in women with diabetes demonstrated that fewer women required treatment with medication when exposed to GPC, and for those requiring treatment with insulin, GPC individuals required less than half the dose. Among women with tobacco use, those who had continued to smoke after finding out they were pregnant were 5 times more likely to quit later in pregnancy if they were engaged in GPC.ConclusionsSeveral groups of high-risk pregnant women may have benefits from engaging in group prenatal care. Because there is a paucity of high-quality, well-controlled studies, more trials in high-risk women are needed to determine whether it improves outcomes and costs of pregnancy-related care.Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1522-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A systematic overview of the literature regarding group prenatal care for high-risk pregnant women

Byerley

Haas

2017

BMC Pregnancy Childbirth

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“…Group prenatal care has been suggested to becost saving and to improve perinatal outcomes including preterm birth, stillbirth, and preeclampsia, and may prove to be an effective strategy for these women. 21 Neonatal intensive care unit admissions are costly, and as such, studies such as this support investing in prenatal care and performing further research to obviate low prenatal care adherence rates. Given the implications of effective diabetes mellitus management on both maternal and fetal well-being, institutions should review their prenatal care adherence rates and develop plans to improve attendance of these women.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Care Adherence and Neonatal Intensive Care Unit Admission or Stillbirth among Women with Gestational and Preexisting Diabetes Mellitus

et al. 2017

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“…In addition, a high level of patient satisfaction has been reported among women receiving group-based antenatal/prenatal care [19,20]. Similarly, in women with gestational diabetes mellitus (GDM) or pre-GDM, groupbased prenatal care has been associated with significantly lower rates of progression from pre-GDM to GDM, lower rates of insulin prescription [21]; and found to be more cost-effective than individual prenatal care [22].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and efficacy of implementing group visits for women’s health conditions: a systematic review

Gerontakos

Leach

Steel

et al. 2023

BMC Health Serv Res

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Background Shared medical appointments, also known as group visits, are a feasible and well-accepted approach for women receiving antenatal care, yet the feasibility and efficacy of this approach for female-specific reproductive conditions is uncertain. Objective The aim of this systematic review was to (a) determine the feasibility of group visits in adults with any female-specific reproductive condition, and (b) identify whether delivering group care for these conditions impacts clinical outcomes. Method Six databases and two clinical trials registries were searched from inception through to 26 January 2022 for original research examining group medical visits or group consultation interventions for adults with female reproductive conditions or pathologic conditions specific to the female reproductive system. Results The search yielded 2584 studies, of which four met the inclusion criteria. Included studies sampled women with breast cancer, chronic pelvic pain, polycystic ovary syndrome and gynaecological cancers. Studies reported high levels of patient satisfaction, with participants indicating their expectations had been met or exceeded. The impact of group visits on clinical outcomes was inconclusive however. Discussion/conclusions The studies in this review indicate delivery of female-specific healthcare via a group model maybe feasible and well-accepted. The review provides a solid basis for proposing larger and longer studies on group visits for female reproductive conditions. Trial registration The review protocol was registered with PROSPERO (CRD42020196995).

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375: Group prenatal care for women with pre-gestational type II diabetes mellitus: a cost-effectiveness analysis

Cited by 6 publications

References 0 publications

A systematic overview of the literature regarding group prenatal care for high-risk pregnant women

A systematic overview of the literature regarding group prenatal care for high-risk pregnant women

Prenatal Care Adherence and Neonatal Intensive Care Unit Admission or Stillbirth among Women with Gestational and Preexisting Diabetes Mellitus

Feasibility and efficacy of implementing group visits for women’s health conditions: a systematic review

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