The effect of group prenatal care for women with diabetes on social support and depressive symptoms: a pilot randomized trial

Abstract

Objective: To measure the impact of group prenatal care (GPC) on diabetes-specific peer support and depressive symptoms in women with pregnancies complicated by diabetes.

Materials and methods: This is a planned secondary analysis of a two-center pilot randomized controlled trial conducted at Denver health (DH) and Washington University in St. Louis (WU) including Spanish (DH) or English (WU) speaking women with type 2 or gestational diabetes. Women were randomized to diabetes GPC or individual prenatal care (IPC) in the resident diabetes clinic. Participants completed an Edinburgh Postnatal Depression Scale (EPDS) at randomization, at 38-week gestation and at 6–12 weeks postpartum. The diabetes support scale (DSS), which includes 12 questions answered on a Likert scale, was administered at 38 weeks. Analysis was by intention to treat (clincaltrials.gov#NCT02444325).

Results: A total of 84 women were consented and randomized. Six withdrew consent (two from each cohort) or were lost to follow-up (two from IPC), and three did not complete the 38-week assessment (two from GPC and one from IPC), resulting in primary outcome data available for 75 women: 38 in GPC and 37 in IPC. More women randomized to GPC reported composite positive peer support on the DSS (52.5 versus 26.3%; p < .02). There were no differences in EPDS scores, depression (EPDS >10), or rates of improved EPDS score from baseline to 38 weeks.

Conclusion: GPC for women with diabetes is associated with improved diabetes-specific peer social support with no significant impact on depressive symptoms.

Clinical trial registration: Clincaltrials.gov NCT02444

Keywords:

• Gestational diabetes
• group prenatal care
• depressive symptoms
• social support

Disclosure statement

The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of the Robert Wood Johnson Foundation or the Administration for Children and Families. The authors report no conflicts of interest or financial disclosures.

Additional information

Funding

Dr. Carter is supported by a NIH T32 training grant (5T32HD055172-05) and the Robert Wood Johnson Foundation Grant #74250. Dr. Mazzoni is supported by an Administration for Children and Families Healthy Marriage and Relationship Grant 90FM0062.