Lower Risk of Developing Gestational Diabetes Mellitus in the Group Prenatal Care Model

Gestational diabetes mellitus (GDM) is a common pregnancy complication with both short- and long-term adverse outcomes for both mothers and their offspring. CenteringPregnancy group prenatal care (CPNC) model has gained popularity due to its unique design to support pregnant individuals in managing multiple risk factors during pregnancy. However, whether participation in CPNC reduces the risk of developing GDM remains uncertain.

To compare the GDM incidence between pregnant individuals receiving CPNC and those receiving traditional individual prenatal care (IPNC).

This retrospective cohort study included 8313 participants (CPNC: 1832; IPNC: 6481) from South Carolina. GDM was screened and diagnosed between 24 and 30 weeks of gestation with the two-step approach. We applied inverse probability of treatment weighting (IPTW) using stabilized propensity score (PS) weights. The weighted risk ratio (RR) of CPNC relative to IPNC for GDM was estimated using weighted marginal log-binomial models.

In the original cohort, the incidence of GDM was 4.7% in the CPNC group and 6.8% in the IPNC group. After applying stabilized IPTW, baseline characteristics were well balanced between groups. In the weighted pseudo-cohort, CPNC was associated with a lower risk of GDM compared with IPNC (RR 0.64, 95% confidence interval [CI] 0.51, 0.81). In subgroup analyses, this inverse association was observed among non-Hispanic White (RR 0.61, 95% CI 0.43, 0.86) and non-Hispanic Black participants (RR 0.69, 95% CI 0.47, 1.00), but not among Hispanic participants (RR 1.05, 95% CI 0.62, 1.77). Results from multivariable logistic regression in the original cohort were consistent in direction but less precise. There was no evidence of additive interaction by race/ethnicity.

Pregnant individuals receiving CPNC had a lower risk of developing GDM than those receiving IPNC.