Discussion
macrosomia, weight gain, depression, blood loss
BLOOD LOSS
This is the first study in China to integrate online and offline services, covering prenatal, natal, and postnatal periods within group care. The findings demonstrated the reduction of CS, excessive prenatal weight gain, postpartum depression, fetal macrosomia in women who participated in the continuous group care combined online and offline service. It also showed the significant increase in GSES scores and the rate of exclusive breastfeeding over the same period when compared to the control group. Furthermore, women in the intervention group demonstrated a high level of participation.In this study, the intervention group demonstrated a higher participation in the face-to-face sessions compared to clinic norms (50-60%) and previous studies [The findings indicated that the intervention group exhibited a significantly high level of engagement with WeChat online services, which may be attributed to the impact of the COVID-19 pandemic [Studies show that the lack of self-efficacy is one of the main reasons caused the increase in the rate of nonmedically indicated cesarean Sect. [Although several studies evaluated the effect of the group care on the gestational weight gain of women have inconsistent results [In this study, there was no significant difference in the duration of each stage of labor or the total duration of labor between the two groups (This study showed that the postpartum 2-hour blood loss in the intervention group was less but not significant than that of the control group(Worldwide, postpartum depression affects approximately 10–15% of women, and the incidence rate in China has reached 15–30% in recent years [A survey of parental demands with regard to the group care found that parents have the highest level of demands for neonatal care [For the neonatal outcomes, the Apgar score is widely used as a clinical index to assess the health of newborns. The result of this study indicated that there was no significant difference in the two groups (Compared to the group care in other studies, the continuous group care with online and offline services begins at 30 weeks with 6 prenatal sessions and 1 postnatal session, rather than starting in the second trimester with 8 to 10 prenatal sessions [