Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 3

Category: Health Equity/Community Health

Poster Session 3

(761) Enhanced group vs. individual prenatal care in preventing preterm birth—EMBRACE randomized comparative-effectiveness trial exploratory findings

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Daisy León-Martínez, MD (she/her/hers)

Assistant Professor
Division of Maternal-Fetal Medicine at the University of California San Francisco
University of California San Francisco, California, United States

Coauthor(s)

DK

Deborah Karasek, MPH, PhD

Assistant Professor
Oregon Health & Science University-Portland State University School of Public Health
Portland, Oregon, United States
CB

Cinthia Blat, MPH

Data Systems Supervisor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
VC

Venise Curry, MD

Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
KC

Kristin Carraway, MPH

Project Manager
Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
KC

Kimberly Coleman-Phox, MPH

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
Brittany D. Chambers Butcher, MPH, PhD (she/her/hers)

Associate Professor
Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
Davis, California, United States
Patience A. Afulani, MBCHB, MPH, PhD (she/her/hers)

Associate Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
Universiy of California San Francisco, California, United States
Bridgette Blebu, PhD, MPH (she/her/hers)

Assistant Professor
Lundquist Institute for Biomedical Innovation - Harbor-UCLA
Los Angeles, California, United States
JF

Jennifer N. Felder, PhD

Associate Professor
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
San Francisco, California, United States
MG

Mary A. Garza, MPH, PhD

Central Valley Health Policy Institute at California State University, Fresno
Fresno, California, United States
Martha A. Tesfalul, MD

Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
San Francisco, California, United States
CD

Christopher Downer, MD

Associate Professor
Medical Education Program, University of California, San Francisco, Fresno
Fresno, California, United States
CM

Charles E. McCulloch, BA, MA, MS, PhD

Professor
University of California, San Francisco
University of California San Francisco, California, United States
Miriam Kuppermann, MPH, PhD (she/her/hers)

Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
University of California San Francisco, California, United States

Objective:
To compare the effect of two enhanced prenatal care models on preterm birth (PTB, < 37 weeks’ gestation).

Study Design:
EMBRACE is a pragmatic, two-arm, randomized comparative-effectiveness trial evaluating depression (primary), care experiences (secondary), and PTB (exploratory) among Medicaid-eligible pregnant people assigned to enhanced group prenatal care (eGPC) vs individual care enhanced (eIPC) by California’s Comprehensive Perinatal Services Program. Primary and secondary outcomes of this analysis, which we prespecified as exploratory due to sample size constraints, are PTB (< 37 weeks’ gestation) and mean gestational age at birth, respectively. Outcome data were obtained from hospital records and participant interviews. We conducted primary analyses by intention-to-treat and subgroup analyses by prenatal care visit attendance and self-reported race and ethnicity (Black, Latine). To estimate the intervention effect, mixed logistic regression models and restricted maximum likelihood mixed linear regression models (adjusted for language of interview with random intercepts for provider) were performed.

Results:
Among 652 participants (n=281 eGPC, n=371 eIPC), self-identified race and ethnicity was 7.4% Black, 72.2% Latine, and 11.2% White. Participants assigned to eGPC were less likely to experience PTB compared to those assigned to eIPC, although the estimate did not reach statistical significance at the alpha 0.05 level (8.7% vs 12.2%; aOR 0.67, 95% CI [0.39, 1.14]). No difference was observed in gestational age at birth (38.7±2.3 vs 38.7±2.1 weeks; aMD 0.03, 95% CI [-0.32, 0.39]). Subgroup analyses suggested higher effectiveness with more eGPC attendance and Latine ethnicity, although differences were not statistically significant (Figure 1). Black subgroup analyses were limited by sample size.

Conclusion:
This exploratory analysis suggests eGPC may reduce PTB rates among low-income individuals. Larger studies are needed to definitively determine whether this model of care reduces preterm birth risk, particularly among low-income Black and Latine populations.