Weekend delivery and maternal–neonatal adverse outcomes in low‐risk pregnancies in the United States: A population‐based analysis of 3‐million live births

Kim, Sooyong; Selya, Arielle

doi:10.1111/birt.12626

Cited by 7 publications

(5 citation statements)

References 45 publications

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“…For the purposes of hospital organization, the allocation of human resources, and provider and support staff convenience, the timing of birth, at least in the United States, appears to have evolved into a pattern that is easier for the maternity care system to manage. A variety of studies of birth outcomes reference an “evening effect” and “weekend effect.” Some of these studies document poorer outcomes during evening and late night hours for both infants [ 45 – 48 ] and birthing people [ 49 ], as well as poorer outcomes on weekends [ 50 ], with organizational limitations in providing care during the night often seen as a contributing factor.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of studies of birth outcomes reference an "evening effect" and "weekend effect." Some of these studies document poorer outcomes during evening and late night hours for both infants [45][46][47][48] and birthing people [49], as well as poorer outcomes on weekends [50], with organizational limitations in providing care during the night often seen as a contributing factor.…”

Section: Plos Onementioning

confidence: 99%

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The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands

et al. 2023

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Objective To examine cross-national differences in gestational age over time in the U.S. and across three wealthy countries in 2020 as well as examine patterns of birth timing by hour of the day in home and spontaneous vaginal hospital births in the three countries. Methods We did a comparative cohort analysis with data on gestational age and the timing of birth from the United States, England and the Netherlands, comparing hospital and home births. For overall gestational age comparisons, we drew on national birth cohorts from the U.S. (1990, 2014 & 2020), the Netherlands (2014 & 2020) and England (2020). Birth timing data was drawn from national data from the U.S. (2014 & 2020), the Netherlands (2014) and from a large representative sample from England (2008–10). We compared timing of births by hour of the day in hospital and home births in all three countries. Results The U.S. overall mean gestational age distribution, based on last menstrual period, decreased by more than half a week between 1990 (39.1 weeks) and 2020 (38.5 weeks). The 2020 U.S. gestational age distribution (76% births prior to 40 weeks) was distinct from England (60%) and the Netherlands (56%). The gestational age distribution and timing of home births was comparable in the three countries. Home births peaked in early morning between 2:00 am and 5:00 am. In England and the Netherlands, hospital spontaneous vaginal births showed a generally similar timing pattern to home births. In the U.S., the pattern was reversed with a prolonged peak of spontaneous vaginal hospital births between 8:00 am to 5:00 pm. Conclusions The findings suggest organizational priorities can potentially disturb natural patterns of gestation and birth timing with a potential to improve U.S. perinatal outcomes with organizational models that more closely resemble those of England and the Netherlands.

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Section: Discussionmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands

et al. 2023

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“…A lower tendency to extubate on weekends could be a contributing factor to prolonged duration of MV. Over the last decades, the weekend effect has been analyzed and discussed in several studies in both adult and maternal-neonatal settings (31)(32)(33)(34)(35). Still, the weekend phenomenon is not yet fully understood, emphasizing the need for further studies exploring actual weekend staffing in relation to respiratory neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Associations between unit workloads and outcomes of first extubation attempts in extremely premature infants below a gestational age of 26 weeks

et al. 2023

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ObjectiveThe objective was to explore whether high workloads in neonatal intensive care units were associated with short-term respiratory outcomes of extremely premature (EP) infants born <26 weeks of gestational age.MethodsThis was a population-based study using data from the Norwegian Neonatal Network supplemented by data extracted from the medical records of EP infants <26 weeks GA born from 2013 to 2018. To describe the unit workloads, measurements of daily patient volume and unit acuity at each NICU were used. The effect of weekend and summer holiday was also explored.ResultsWe analyzed 316 first planned extubation attempts. There were no associations between unit workloads and the duration of mechanical ventilation until each infant’s first extubation or the outcomes of these attempts. Additionally, there were no weekend or summer holiday effects on the outcomes explored. Workloads did not affect the causes of reintubation for infants who failed their first extubation attempt.ConclusionOur finding that there was no association between the organizational factors explored and short-term respiratory outcomes can be interpreted as indicating resilience in Norwegian neonatal intensive care units.

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“…A response to: Weekend delivery and maternal-neonatal adverse outcomes in low-risk pregnancies in the United States: A population-based analysis of 3 million live births Kim et al 1 report that weekend birth is associated with higher odds of adverse maternal and fetal outcomes compared with weekday birth and suggest that modifiable factors inherent to the weekend may underlie the observed higher risk. While they acknowledge that the occurrence of a greater proportion of high-risk births on the weekend could produce a similar finding, they contend that their analysis, which was designed to include only low-risk births and was adjusted for numerous risk factors, has adequately controlled for patient acuity.…”

Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 99%

A response to: Weekend delivery and maternal–neonatal adverse outcomes in low‐risk pregnancies in the United States: A population‐based analysis of 3 million live births

Cohen¹

2022

Birth

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Weekend delivery and maternal–neonatal adverse outcomes in low‐risk pregnancies in the United States: A population‐based analysis of 3‐million live births

Cited by 7 publications

References 45 publications

The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands

The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands

Associations between unit workloads and outcomes of first extubation attempts in extremely premature infants below a gestational age of 26 weeks

A response to: Weekend delivery and maternal–neonatal adverse outcomes in low‐risk pregnancies in the United States: A population‐based analysis of 3 million live births

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