Outcomes of Latina women in CenteringPregnancy group prenatal care compared with individual prenatal care.

INTRODUCTION: CenteringPregnancy is a client-centered model of group prenatal care that brings women together into small groups to receive care through assessment, education, and support. As Spanish-speaking CenteringPregnancy groups become more common, outcomes of Latinas who attend these groups must be assessed. The purpose of this retrospective cohort study was to compare pregnancy outcomes of Latina women who completed CenteringPregnancy in a public health clinic with women who completed individual care in the same clinic during the same time. METHODS: Medical charts were reviewed retrospectively to examine differences in pregnancy outcomes and maternal factors in both prenatal care groups. Latina Spanish-speaking women who completed CenteringPregnancy were matched with Latina Spanish-speaking women who completed individual care within the same time frame. Logistic regression analysis was conducted to examine maternal and birth outcomes. RESULTS: A total of 487 patient charts were obtained for data collection (CenteringPregnancy n = 247, individual n = 240). No differences in low-birth-weight or preterm births were observed between the groups. Compared with women in individual care, women in CenteringPregnancy had higher odds of giving birth vaginally (adjusted odds ratio [aOR], 2.57; 95% confidence interval [CI], 1.23-5.36), attending prenatal care visits (aOR, 11.03; 95% CI, 4.53-26.83), attending postpartum care visits (aOR, 2.20; 95% CI, 1.20-4.05), and feeding their infants formula only (aOR, 6.07; 95% CI, 2.57-14.3). Women in CenteringPregnancy also had lower odds of gaining below the recommended amount of gestational weight (aOR, 0.41; 95% CI, 0.22-0.78). DISCUSSION: Women in CenteringPregnancy had higher health care utilization, but there were no differences in preterm birth or low birth weight. Randomized studies are needed to eliminate selection bias.

Estimating maternal mortality in Monseñor Nouel Province, Dominican Republic.

OBJECTIVES: Maternal deaths are estimated by the World Health Organization at over 500,000 annually. Various methods of calculating mortality ratios have been utilized throughout the world, but many are inaccurate. The purpose of this study was to measure maternal mortality by using a sibling survivorship survey and by recording and tracking death certificates. METHODS: The data for the survey were collected within a specific province in the Dominican Republic that represents predominately rural communities. Interviews with 2,180 women and data from their 17,807 siblings were recorded, 9,723 of which were sisters. The Death Certificate data were obtained by tracking 3,430 records at the local government office in the same province. RESULTS: The results from the rural sibling survey show a maternal mortality ratio significantly higher than other national estimates (348/100,000 live births versus 72-250/100,000). Data collection methods are discussed, including government record keeping and potential sources of inaccuracy. CONCLUSION: Reported maternal mortality ratios may not portray the true magnitude of the poor health status of women in developing countries.