Delivery Outcomes after Centering versus Routine Prenatal Care

OBJECTIVE The objective of this study was to compare delivery outcomes among women in Northern Manhattan undergoing Centering versus routine prenatal care. METHODS This retrospective cohort study analyzed prenatal care and delivery hospitalizations among women receiving prenatal care at two ambulatory clinics in Northern Manhattan from 2013 to 2018. The exposure of interest was Centering versus routine prenatal care. The primary outcome of interest was preterm birth < 37 weeks. Other clinical outcomes analyzed included number of prenatal visits, birth weight including very low birth weight (<1500g), cesarean versus vaginal delivery, and preterm birth <32 weeks. Unadjusted and adjusted logistic regression models (accounting for demographic factors) were performed to analyze the association between the exposure of Centering prenatal care and the primary outcome with unadjusted (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CI) as measures of association. RESULTS A total of 714 women undergoing Centering prenatal care and 9,469 women undergoing traditional prenatal care were included in the analysis. Evaluating the primary outcome of preterm birth <37 weeks, Centering was associated with a 5.9% risk of preterm birth compared to 7.1% with routine prenatal care (OR 0.84, 95% CI 0.53-1.30). Centering prenatal care was also not significantly associated with very low birth weight (OR 0.4, 95% CI 0.1-1.7), birth weight <2500g (OR 0.65, 95% CI 0.40, 1.06), or preterm birth at 32-36 weeks (OR 1.0, 95% CI 0.8, 1.2). Centering prenatal care was associated with lower odds of cesarean delivery (OR 0.71, 95% CI 0.60-0.84) and more frequent prenatal visits. CONCLUSION Centering prenatal care was associated with lower likelihood of cesarean delivery and more frequent prenatal visits while likelihood of preterm birth and low birthweight were not significantly more or less likely with Centering.