PARTICIPATION IN CENTERINGPREGNANCY PROGRAM AND PREGNANCY-INDUCED HYPERTENSION.

INTRODUCTION: CenteringPregnancy emphasizes nutrition, learning, and peer support through a group meeting format in contrast to the standard of prenatal care (SPNC) that maximizes a pregnant patient's time with their provider. We hypothesized that the program may yield a reduced risk of pregnancy-induced hypertension (PIH). In this observational study, we examined the effect of the CenteringPregnancy program versus SPNC on PIH.

METHODS: In 2021, birth certificate data were linked to hospital discharge records of women who delivered in obstetric clinics in the Midlands of South Carolina between 2015 and 2019. Logistic regression models were used to estimate the association between CenteringPregnancy participation (n=547) and any PIH and specific PIH diagnoses (gestational hypertension/unspecified hypertension, mild pre-eclampsia, and severe pre-eclampsia/eclampsia). Propensity score techniques (e.g., inverse probability of treatment weighting [IPTW]) were used to adjust for self-selection into the program versus SPNC.

RESULTS: CenteringPregnancy participants had higher odds of developing any PIH under all specifications (OR 1.48, 95% CI, 1.15, 1.92) and specifically, gestational hypertension/unspecified hypertension (OR 1.76, 95% CI, 1.28, 2.42) than those in SPNC. However, CenteringPregnancy participants did not experience significant higher odds of mild pre-eclampsia (OR 1.06, 95% CI, 0.65, 1.78) and severe pre-eclampsia/eclampsia (OR 1.21, 95% CI, 0.78, 1.89) compared to SPNC.

CONCLUSIONS: Participation in CenteringPregnancy, compared to SPNC, was associated with higher odds of PIH, particularly gestational hypertension. Additional research is warranted to definitely rule out selection bias and identify contributing factor(s) that increased PIH despite efforts to improve pregnancy-related health outcomes among CenteringPregnancy participants.