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Clinical Obstetrics

Poster Session 1

(150) Looking for a blueprint for changing patient behavior: Group Prenatal Care improves breastfeeding knowledge

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Despite providing both maternal and neonatal benefits, breastfeeding rates remain lower than goal targets. Prior research suggests that breastfeeding initiation rates are higher for group prenatal care (GPNC) compared to individual care (IPNC), but little is known about its effectiveness for improving breastfeeding knowledge and self-efficacy.

Study Design: This is a secondary analysis of the Centering and Racial Disparities (CRADLE) randomized control trial comparing the impact of GPNC vs IPNC on preterm birth. The primary analysis used an intent-to-treat (ITT) approach and the primary outcome was breastfeeding at hospital discharge. Patient surveys administered prior to delivery included questions on breastfeeding knowledge (adapted from the Infant Feeding Practices II Survey) and self-efficacy (adapted from Wells’ 20-item Prenatal Breast-feeding Self-efficacy Scale). A subgroup analysis was conducted on primigravid patients.

Results: 2350 participants were enrolled and 80.4% (1890) completed the surveys. Participants identified as either African American (40.6%), Hispanic (21.4%), White (36.8%), or Other race/ethnicity (1.3%) and 62.7% were primigravid. Compared with IPNC, GPNC did not improve breastfeeding at hospital discharge (71.7% IPNC vs 72.0% GPNC; OR 1.02, 95% CI 0.84 – 1.23). Participants assigned to GPNC were more likely to provide correct answers for all knowledge questions (p ≤ 0.04) except one item and scored higher (p=0.007) on the composite knowledge score when compared to IPNC (Table 1). These findings were consistent for primigravid participants, but no significant differences were noted for multigravid participants. There was no difference (p > 0.29) in self-efficacy questions by prenatal care type.

Conclusion: GPNC increased breastfeeding knowledge, especially for primigravid patients, but this did not translate into increased rates of breastfeeding at hospital discharge.