Quality of Prenatal Care and Pregnancy Outcomes: Centering Pregnancy Versus Traditional Prenatal Care

Prenatal care provides a unique opportunity for healthcare providers to improve outcomes for women and their families and by extension community health. Therefore, prenatal care has the opportunity to become the cornerstone of healthcare in our nation. It can influence the health of the mother, newborn, and family unit long beyond the course of a 9-month pregnancy. However, evidence supporting positive outcomes from current tradition based models of prenatal care is lacking. The current United States prenatal system limits the patient-provider relationship, does not empower the patient, lacks emphasis on education, and is not woman-centered. The aim of the study was to compare an alternative prenatal care model, Centering Pregnancy, to individual prenatal care. An initial comparative concept analysis of power and empowerment focused on the nurse’s role in cultivating empowerment in the pregnant woman. Subsequently, a study exploring the differences in outcomes for women in two different prenatal care groups was conducted. Differences examined included quality of prenatal care and pregnancy-related empowerment from the patient’s perspective. Also comparison of birth weight and gestational age at time of birth for a sample size of 51 pregnant patients (n =14 in Centering Pregnancy, n=37 in individual prenatal care). Findings from this feasibility study revealed no statistical significance between the two independent groups in quality of prenatal care and gestational age. Differences in pregnancy-related empowerment (p = 0.083) and birth weight (p = 0.088) were noted to be approaching significance. Participants receiving individual prenatal care demonstrated higher post pregnancy-related empowerment. Centering Pregnancy participants had higher birth weights. The results call for further research into the effect of Centering Pregnancy on empowerment and birth weight with a larger sample size to determine if true significance exists

A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk

Background This review provides a reappraisal of the potential effects of dairy foods, including dairy fats, on cardiovascular disease (CVD)/coronary heart disease (CHD) risk. Commodities and foods containing saturated fats are of particular focus as current public dietary recommendations are directed toward reducing the intake of saturated fats as a means to improve the overall health of the population. A conference of scientists from different perspectives of dietary fat and health was convened in order to consider the scientific basis for these recommendations. Aims This review and summary of the conference focus on four key areas related to the biology of dairy foods and fats and their potential impact on human health: (a) the effect of dairy foods on CVD in prospective cohort studies; (b) the impact of dairy fat on plasma lipid risk factors for CVD; (c) the effects of dairy fat on non-lipid risk factors for CVD; and (d) the role of dairy products as essential contributors of micronutrients in reference food patterns for the elderly. Conclusions Despite the contribution of dairy products to the saturated fatty acid composition of the diet, and given the diversity of dairy foods of widely differing composition, there is no clear evidence that dairy food consumption is consistently associated with a higher risk of CVD. Thus, recommendations to reduce dairy food consumption irrespective of the nature of the dairy product should be made with cautionJ. Bruce German, Robert A. Gibson, Ronald M. Krauss, Paul Nestel, Benoît Lamarche, Wija A. van Staveren, Jan M. Steijns, Lisette C. P. G. M. de Groot, Adam L. Lock and Frédéric Destaillat