A randomized trial of augmented prenatal care for multiple-risk, Medicaid-eligible African American women
Open accessAbstract
OBJECTIVES: This project investigated whether augmented prenatal care for high-risk African American women would improve pregnancy outcomes and patients' knowledge of risks, satisfaction with care, and behavior. METHODS: The women enrolled were African American, were eligible for Medicaid, had scored 10 or higher on a risk assessment scale, were 16 years or older, and had no major medical complications. They were randomly assigned to augmented care (n = 318) or usual care (n = 301). Augmented care included educationally oriented peer groups, additional appointments, extended time with clinicians, and other supports. RESULTS: Women in augmented care rated their care as more helpful, knew more about their risk conditions, and spent more time with their nurse-providers than did women in usual care. More smokers in augmented care quit smoking. Pregnancy outcomes did not differ significantly between the groups; however, among patients in augmented care, rates of preterm births were lower and cesarean deliveries and stays in neonatal intensive care units occurred in smaller proportions. Both groups had lower-than-predicted rates of low birthweight. CONCLUSIONS: High-quality prenatal care, emphasizing education, health promotion, and social support, significantly increased women's satisfaction, knowledge of risk conditions, and perceived mastery in their lives, but it did not reduce low birthweight.
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Even though early prenatal care became more accessible over the past 20 years, outcomes did not improve.
“Despite increased access to early prenatal care over the course of the past 20 years, outcomes have not improved.5,6”
From Reaching Women through Health Information Technology: The Gabby Preconception Care System (2013) · cites this paper as [5]
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Reaching Women through Health Information Technology: The Gabby Preconception Care System
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- Authors
- Klerman, L. V., Ramey, S. L., Goldenberg, R., Marbury, S., Hou, J., & Cliver, S.
- Affiliations
- University of Alabama at Birmingham (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2001-01-01
- Volume
- 91
- Issue
- 1
- Pages
- 105-111
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC1446489
- OpenAlex
- W2138670652
- Cited by
- 130
- References
- 20
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 1 · 2019: 7 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 17.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Civitan International
- U.S. Public Health Service (MC J9040, 290-92-0055)
- Topics
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- high-risk pregnancy, African American women, peer support groups, patient education, patient satisfaction, smoking cessation, preterm birth, cesarean section, neonatal intensive care, low birth weight, health promotion, social support, perceived mastery
- MeSH terms
- Adolescent, Adult, Alabama, Black or African American, Female, Humans, Health Knowledge, Attitudes, Practice, Medicaid, Patient Education as Topic, Pregnancy, Pregnancy Outcome, Prenatal Care, Prospective Studies, Social Support, United States, Patient Satisfaction, Outcome Assessment, Health Care, Pregnancy, High-Risk
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