Diabetes Group Prenatal Care

Not Applicable

Completed

Brief Summary: The investigators primary objective is to conduct a pilot randomized trial to determine the effect of group prenatal care on self-care activities in women with diabetes.

Detailed Description: Long term, the investigators aim to test the central hypothesis that group prenatal care, compared to traditional prenatal care, will improve glycemic control and, ultimately, maternal and neonatal outcomes in women with type 2 and gestational diabetes. The objective of this proposal is to conduct a pilot randomized trial to determine the effect of group prenatal care on self-care activities, which have been associated with improved glycemic control, in women with diabetes.

Recruitment & Eligibility

Inclusion Criteria

English (WUMC) or Spanish speaking (DH)
Type 2 White's Class B diabetes OR gestational diabetes diagnosed by 2-step method < 32 weeks
Ability to attend group prenatal visit at specified days and times
Willingness to be randomized
Randomization at 22 weeks 0 days-32 weeks 0 days
Ability to give informed consent

Exclusion Criteria

Multiple gestation
Major fetal anomaly
Serious medical co-morbidity necessitating more care than can be safely provided in group setting, as deemed by medical provider
Serious psychiatric illness including schizophrenia necessitating more care than can safely be provided in group setting, as deemed by medical provider

Arm && Interventions

Group	Intervention	Description
Group prenatal care	Group prenatal care	Group visits will be held every 2 weeks in a continuous cycle through a four session curriculum. Women will have weekly visits beginning at 37 weeks with traditional prenatal visits on the weeks when the group does not meet. Groups of 4-12 women will meet for two hour visits and much of that time will be spent on pregnancy, behavioral health, diabetes and nutrition education. Groups will be co-facilitated by 2 CenteringPregnancy trained providers at each site and an obstetric provider. Women may be instructed to have additional visits in the traditional clinic at the discretion of the obstetric provider.

Primary Outcome Measures

Name	Time	Method
effect of group prenatal care on maternal diabetes self-care activities as measured Diabetes Self-Care Activities Measure	37-39 weeks gestation	Determine the effect of group prenatal care on maternal diabetes self-care activities as measured by the Diabetes Self-care Activities Measure and confirmed by percentage of recommended blood glucose values completed on logs since initial study visit.

Secondary Outcome Measures

Name	Time	Method
effect of group prenatal care on perinatal mood as measured by Edinburgh Postnatal Depression Scale	baseline and 4-12 weeks postpartum	Determine the effect of group prenatal care on perinatal mood as measured by the Edinburgh Postnatal Depression Scale
Birthweight	delivery admission	Determine the effect of group prenatal care on birthweight
effect of group prenatal care on perceived social support as assessed by the Social Support Scale	37-39 weeks	Determine the effect of group prenatal care on perceived social support through the Social Support Scale
Contraception	4-12 weeks postpartum	Determine the effect of group prenatal care on initiating contraception
Gestational age at delivery	delivery admission	Determine the effect of group prenatal care on preterm delivery
Mean 3rd trimester fasting blood glucose	baseline through delivery	Determine the effect of group prenatal care on maternal glycemic control through mean 3rd trimester fasting glucose
Breastfeeding	4-12 weeks postpartum	Determine the effect of group prenatal care on initiating breastfeeding

Locations (2): Washington University in St. Louis
🇺🇸
Saint Louis, Missouri, United States
Denver Health
🇺🇸
Denver, Colorado, United States