Centering Pregnancy Model: EBP for Reducing Low Birth Weight Infants

Objective(s): To evaluate current research and evidence addressing effects of low-income on women and their fetuses in an effort to identify a population health intervention to prevent low birth weight (<2500 grams) infants in Lubbock County located in the southwestern United States.

Background: Lubbock County documented 1,306 low birthweight births out of 29,000 live births from 2006-20012 (10.1%) with error margin 9.8-10.5 (Z=1.27) (County Health Rankings, 2015). Lubbock County’s birth weights ranked in Texas’ top 10 counties for low birth weights for 2015. Seven of the top 10 counties are in close proximity to Lubbock County and include; Terry, Swisher, Scurry, Fisher, Crosby, and Dawson. County Health Rankings associated teen pregnancy with both late or no prenatal care and preterm deliveries, thus increasing the likelihood of delivering low birth weight infants. Lubbock County’s surrounding counties have some of the highest teen birth rates in Texas.

Methods: Electronic databases searched were The National Library of Medicine database, Cumulative Index to Nursing and Allied Health, and the Cochrane Library of systematic reviews. Literature and governmental data sources were explored to assess evidence and guidelines to gain an understanding of the population health problem. Key community informants were interviewed.

Results: Published literature linked poverty, teen pregnancy, and stress to low birth weight infants. Lack of social support predicted preterm birth, low birth weights, and infant death. Centering Pregnancy Model was identified as an evidence-based practice addressing limited social support, thus decreasing stressors and increasing resources. Gathered evidence was presented and recommended to Covenant Health’s Prenatal Care Center due to their providing care primarily to low-income women in Lubbock and surrounding counties. Synthesized findings presented to clinic staff and administrators provided evidence supporting adoption of Centering Pregnancy Model in their low-income population.

Conclusions: Centering Pregnancy Model allows for positive peer influences, community building, increased motivation for change and learning, and sharing of common life experiences with the group. The strengths of Centering Pregnancy Model support improvement in birth outcomes for low-income pregnant women in Lubbock County, United States.