Lauren Gatta

A new study at the School of Public Health and Vanderbilt University Medical Center has found that group prenatal care can reduce the risk of premature birth.

The study — which tracked 9,348 pregnant women from 2009 to 2016 — found that women who received prenatal care in group settings were less likely to deliver prematurely or conceive babies with low birth weights, compared to those who received individual prenatal care. According to the researchers, the study’s findings provide incentive for more health care providers to offer group prenatal care and raise important questions about what causes preterm births — the main cause of newborn deaths worldwide. The study was published in the Journal of Women’s Health on Sept. 25.

“The biggest issue in accessibility is that [group prenatal care] isn’t available in most practices, so only about 3 percent of women in the U.S. has access to group prenatal care in their community,” said Jessica Lewis, Deputy Director of Pregnancy Research at the School of Public He alth and co-author of the study. “With more and more findings coming out talking about the benefits of group prenatal care, hopefully more providers will provide care in this way.”

Group prenatal care sessions typically involve one-on-one check-ups with health care providers, individual self-care activities, such as tracking blood pressure and weight, and facilitated discussions on childbirth and pregnancy. The soon-to-be mothers generally attend these sessions with seven to 11 other women due in the same month.

Using a “propensity score matching” methodology to account for differences other than prenatal care, the team found that compared to individual care-only patients, risk of preterm birth and low birth weight among women who attended five or more group prenatal care sessions decreased by 68 percent.

Lewis told the News that group prenatal care may yield more positive birth outcomes because it reduces women’s stress. She explained that social support that women receive from group sessions likely helped their cervical lengths remain longer for longer periods of time, which reduced the likelihood of preterm birth.

According to Lewis, those who receive group care attend longer care sessions that typically last for two hours compared to individual sessions, which only last for 10 to 15 minutes.

As part of the study, the researchers built their own model of group prenatal care with funding from a United Healthcare provider, Expect With Me. The model incorporates an information technology infrastructure that allows pregnant women to connect with each other over social media platforms and send messages to their providers.

Despite the positive outcomes that group prenatal care yields, only 3 percent of women in the U.S. have access to this type of care, according to Lewis. Because individual prenatal care is the standard practice for most health care providers across the country, she said, many are reluctant to change their systems.

Still, the study’s illustration of a concrete correlation between group care and positive birth outcomes will likely incentivize providers to adopt group prenatal care models, Lewis said.

“Part of the challenge is to engage the payers — the insurance companies and Medicaid — to incentivize providers to change the way they practice,” she said. “They save about $1,000 per pregnancy for women enrolled in group care; keeping those babies out of the neonatal intensive unit is a major money saver for them.”

It remains unclear exactly how providers should implement group prenatal care to maximize positive birth effects, said Shayna Cunningham, scientist at the School of Public Health and lead author of the study.

Cunningham said that the team has already started to investigate whether a certain number of group visits are necessary to yield positive outcomes. They are also studying whether group care models work for a more diverse population in terms of age, ethnic group and socioeconomic status.

Lewis added that she and her team are performing further studies to better understand exactly how group prenatal care improves birth outcomes.

The United States ranks 54th globally in 2010 for worst preterm birth rates, one rank above Thailand, according to the World Health Organization.

Jasmine Sui-shin.su@yale.edu .