Induction of labour, birthweight and perinatal mortality by day of the week

Abstract

There were 46 974 births at the three largest Dublin maternity hospitals in the years 1980-1982. Data on numbers of spontaneous and elective births, birthweight and perinatal mortality were analysed by day of the week. Perinatal mortality rates were highest on Wednesdays and Saturdays. The rate on Sunday was close to average. The largest number of perinatal deaths per day occurred on Wednesdays and the smallest on Sundays. Significant variations in mortality rates and percentage low birthweight were found among the 19% of infants who were born electively, but not among those born after a spontaneous onset of labour. High-risk pregnancies, including many with intrauterine fetal death, were induced in large numbers from Tuesdays through Saturdays with a peak on Wednesdays. Low risk cases were induced mainly from Monday through Fridays with a peak on Fridays. The pattern of perinatal mortality through the week followed closely that of the risk status of pregnancies delivered electively. The results indicate that the pattern of perinatal mortality by day of the week of birth was determined by a highly organized weekly routine of selective elective delivery. MacFarlane (1978) reported that perinatal mortality rates were highest in England and Wales among infants born on Saturdays and Sundays in all 7 years between 1970 and 1976 inclusive. In 5 years Sunday had the highest rate, and in 1 9 7 s 1973 the highest weekday rate occurred on Monday. Fewest births occurred on Sunday, followed by Saturday and Monday, thus the highest

Association Between Evening Admissions and Higher Mortality Rates in the Pediatric Intensive Care Unit

“…24 Although earlier neonatal studies noted higher weekend mortality rates, those analyses likely did not adjust adequately for potential confounders. 4,[6][7][8] Interestingly, the lack of a weekend effect in the current study and the recent neonatal study 24 differs from the results observed by Bell and Redelmeier, 1 who evaluated mortality rates among adult emergency admissions between 1988 and 1997 in Ontario, Canada. The difference between these findings may represent differences between adult and pediatric patient populations or a distinction between the structure or processes of health care for adult versus pediatric patients.…”

“…Similarly, neonatal mortality rates were shown to be slightly higher among infants born on weekends and during evening hours, compared with those born on weekdays and during daytime hours, respectively. [3][4][5][6][7][8] Whether an association exists between patient outcomes and time of admission in the pediatric patient population is unknown.To address this question, the Pediatric Intensive Care Unit Evaluations (PICUEs) database, representing a cohort of 34 993 pediatric ICU (PICU) patients from 15 institutions in the United States, was analyzed. 9 The objectives of this study were to compare the risk-adjusted mortality rates for weekend admissions versus weekday admissions and the risk-adjusted mortality rates for evening admissions versus daytime admissions.…”

“…Similarly, neonatal mortality rates were shown to be slightly higher among infants born on weekends and during evening hours, compared with those born on weekdays and during daytime hours, respectively. [3][4][5][6][7][8] Whether an association exists between patient outcomes and time of admission in the pediatric patient population is unknown.…”

Weekend working: a retrospective cohort study of maternal and neonatal outcomes in a large NHS delivery unit

“…However, studies specifically comparing weekends to weekdays suggest no differences in neonatal death rates (5–7). Aside from neonatal mortality, there is little evidence regarding rates of other serious adverse outcomes during weekends compared to weekdays, despite their potentially profound impacts on women and infants.…”

Bargaining Over Labor: Do Patients Have Any Power?

“…14 A spate of studies has analyzed the question of whether weekend births are more dangerous (see for example MacFarlane, 1978;1979;Mangold, 1981;Hendry, 1981;Mathers, 1983;Dowding et al, 1987;Gould et al, 2003;Luo et al, 2004;Hong et al, 2007). The majority of these papers find that while the infant mortality rate is higher on weekends, this does not necessarily mean that it is more dangerous for a given child to be born on a weekend.…”