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Neonatal mortality in weekend vs weekday births.
Jeffrey B Gould1, Cheng Qin, Amy R Marks
1School of Public Health, University of California, Berkeley, USA. jbgould@stanford.edu
JAMA
|June 12, 2003
Summary
Neonatal mortality rates for infants born on weekends were slightly higher, but this difference disappeared after accounting for birth weight. This suggests no compromise in perinatal care quality over weekends.
Area of Science:
- Perinatal medicine
- Neonatal health
- Public health
Background:
- Historical concerns about weekend neonatal mortality exist.
- Contemporary data on daily variations in neonatal outcomes are lacking.
- Concerns about weekend healthcare adequacy persist.
Purpose of the Study:
- To compare neonatal mortality between weekday and weekend births.
- To evaluate daily patterns in births, obstetric interventions, and case mix-adjusted mortality.
Main Methods:
- A case series analysis of 1,615,041 live births in California (1995-1997).
- Stratified analyses by birth weight and delivery method.
- Logistic regression used to estimate birth weight-adjusted odds ratios for weekend mortality.
Main Results:
- Weekend births decreased by 17.5%, with fewer cesarean deliveries.
- A higher proportion of very low-birth-weight infants were born on weekends.
- Observed neonatal mortality was higher on weekends, but this difference was not significant after adjusting for birth weight.
Conclusions:
- The goal of optimal perinatal care irrespective of day of the week is crucial.
- Birth weight-adjusted analysis revealed no evidence of compromised perinatal care quality on weekends in California.
- Findings indicate that birth weight is a key factor in understanding weekend neonatal mortality differences.
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