Targeted Lifestyle Change Group Prenatal Care

Inclusion Criteria:

• English speaking

• ≤16 weeks gestation

• Two or more of the following GDM risk factors:

• BMI ≥ 25

• Physical inactivity

• First degree relative with diabetes

• High risk race or ethnicity (African American, Latino, Native American, AsianAmerican, Pacific Islander)

• Prior infant weighing ≥ 4,000 g

• Prior GDM

• Hypertension (140/90 mm Hg or receiving treatment)

• High-density lipoprotein cholesterol level <35 mg/dL or triglycerides > 250 mg/dL

• Polycystic ovarian syndrome

• A1c ≥ 5.7%

• Impaired glucose tolerance

• Impaired fasting glucose on previous testing

• History of cardiovascular disease

• Ability to attend group prenatal visits at specified days and times

• Willingness to be randomized

• Ability to give informed consent

Exclusion Criteria:

• Type 2 diabetes (eligible for Diabetes Group Care)

• Positive glucose challenge test during early pregnancy

• Multiple gestation (require extra care)

• Major fetal anomaly (require extra care)

• Serious medical co-morbidity necessitating more care than can be safely provided ingroup setting, as deemed by medical provider (require extra care)

• Serious psychiatric illness, including schizophrenia, necessitating more care thancan be safely provided in group setting, as deemed by medical provider (requireextra care)