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Resuscitation outcomes for weekend deliveries of very low birthweight infants

Emily Hawkins Carter1, Henry C Lee2, Wannasiri Lapcharoensap3

  • 1Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA cartere@ohsu.edu.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|May 17, 2020
PubMed

Insights

Infants born on weekends had increased need for chest compressions and lower Apgar scores. This study highlights potential disparities in care for very low birthweight (VLBW) infants during weekend deliveries.

Area of Science:

  • Neonatal care and outcomes
  • Perinatal epidemiology
  • Healthcare quality and disparities

Background:

  • Weekend hospital admissions are associated with varying patient outcomes across different medical specialties.
  • Understanding potential disparities in neonatal intensive care unit (NICU) delivery room management based on day of the week is crucial for optimizing infant outcomes.

Purpose of the Study:

  • To investigate the association between weekend (Saturday and Sunday) deliveries of very low birthweight (VLBW) infants and delivery room outcomes within the first hour of life.
  • To identify potential differences in neonatal resuscitation and immediate post-birth care for VLBW infants born on weekends versus weekdays.

Main Methods:

  • Retrospective cohort study utilizing data from the California Perinatal Quality Care Collaborative.
  • Included 26,515 very low birthweight infants born between 2010 and 2016.
  • Analyzed delivery room outcomes including chest compressions, epinephrine use, intubation timing, 5-minute Apgar scores, hypothermia, and early mortality, adjusting for infant, maternal, and hospital factors.

Main Results:

  • Weekend deliveries were associated with a higher likelihood of requiring chest compressions (OR: 1.12) and lower 5-minute Apgar scores (OR: 1.11) compared to weekday deliveries, after adjusting for sex and race.
  • Infants born on weekends had similar gestational age, ethnicity, sex, and maternal risk factors but were less likely to have been diagnosed with intrauterine growth restriction prenatally.
  • Caesarean deliveries were less frequent on weekends, while vaginal delivery rates remained consistent across all days.

Conclusions:

  • Weekend delivery of very low birthweight infants in California was associated with an increased need for chest compressions and lower 5-minute Apgar scores.
  • Further research is warranted to explore the underlying reasons for these observed differences and to develop strategies to mitigate potential weekend-related disparities in neonatal care.
Abstract

Keywords:
health services researchneonatologyresuscitation

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