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Mortalidad neonatal en fin de semana frente a nacimientos en días laborables
Jeffrey B Gould1, Cheng Qin, Amy R Marks
1School of Public Health, University of California, Berkeley, USA. jbgould@stanford.edu
JAMA
|June 12, 2003
Resumen
Las tasas de mortalidad neonatal para los bebés nacidos los fines de semana fueron ligeramente más altas, pero esta diferencia desapareció después de tener en cuenta el peso al nacer. Esto sugiere que no hay compromiso en la calidad de la atención perinatal durante los fines de semana.
Área de la Ciencia:
- La medicina perinatal es una medicina para el perinatal.
- Salud neonatal en la salud neonatal.
- Salud pública La salud pública es la salud pública.
Sus antecedentes:
- Existen preocupaciones históricas sobre la mortalidad neonatal durante el fin de semana.
- Faltan datos contemporáneos sobre las variaciones diarias en los resultados neonatales.
- Persisten las preocupaciones sobre la adecuación de la atención médica durante el fin de semana.
Objetivo del estudio:
- Para comparar la mortalidad neonatal entre los nacimientos entre semana y el fin de semana.
- Para evaluar los patrones diarios en los nacimientos, las intervenciones obstétricas y la mortalidad ajustada por la mezcla de casos.
Principales métodos:
- Un análisis de una serie de casos de 1.615.041 nacimientos vivos en California (1995-1997).
- Análisis estratificados por peso al nacer y método de parto.
- Regresión logística utilizada para estimar las tasas de probabilidades ajustadas al peso al nacer para la mortalidad por fin de semana.
Principales resultados:
- Los partos de fin de semana disminuyeron un 17,5%, con menos partos por cesárea.
- Una mayor proporción de bebés de muy bajo peso al nacer nacieron los fines de semana.
- La mortalidad neonatal observada fue mayor los fines de semana, pero esta diferencia no fue significativa después de ajustar por el peso al nacer.
Conclusiones:
- El objetivo de una atención perinatal óptima, independientemente del día de la semana, es crucial.
- El análisis ajustado al peso al nacer no reveló evidencia de una calidad comprometida de la atención perinatal los fines de semana en California.
- Los hallazgos indican que el peso al nacer es un factor clave para comprender las diferencias de mortalidad neonatal durante el fin de semana.
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