Outcomes for pregnant women with less healthy behaviours participating in CenteringPregnancy

Objective: This study aims to explore whether the effect of participation in CenteringPregnancy (CP) on various health outcomes differs between women with healthy and less healthy behaviours at the start of pregnancy. Latent class analysis previously identified four subgroups: healthy primigravida and multigravida, less healthy women and less healthy, stressed women. Methods: The study was conducted as a stepped-wedge cluster randomized trial. Data were collected through questionnaires, supplemented with perinatal data from the Netherlands' national Perined database. Multilevel logistic regression was performed to compare outcomes of the subgroups of women in the control group to subgroups of women receiving individual care and CP. Results: Participation in CP was significantly associated with a decreased likelihood of using pain relief medication during labour and birth, induced labour, non-optimal maternal events, stress, and increased health behaviour knowledge in less healthy, stressed women. Smoking rates decreased and use of healthcare increased in the less healthy group. Both healthy primigravida and multigravida women in CP were less likely to consume alcohol postpartum, attended more antenatal care, and reported higher satisfaction with care. Pregnancy knowledge increased for healthy primigravida women and use of coping strategies increased among healthy multigravida women. Breastfeeding rates increased in all groups, except for less healthy, stressed women. Conclusion: CP participation has a positive impact on the maternal health of women with less healthy behaviours, as well as those with healthy behaviours. Since the positive impact of CP is not limited to women with less healthy behaviours, it is worthwhile to offer CP to all pregnant people in the Netherlands.