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Pregnancy

23rd Jan 2017

Now There’s A Link Between Weekend Births And Mother And Baby Deaths

Alison Bough

Monday’s child is fair of face, Tuesday’s child is full of grace, Wednesday’s child is full of woe, Thursday’s child has far to go, Friday’s child is loving and giving, Saturday’s child works hard for a living, but the child who is born on the Sabbath day is bonnie and blithe and good and gay.

So goes the old rhyme but new research, due to be presented this Friday at the annual meeting of the Society for Maternal-Foetal Medicine, warns that having a baby at the weekend carries a significantly higher risk to both mothers and babies.

Researchers from the Baylor College of Medicine in Houston, Texas, have found a link between day of delivery and maternal-foetal mortality. Their study is based on data from the US Centre for Disease Control and Prevention, which shows that the country’s maternal death rate is three to four times higher than that of most other developed nations.

The maternal mortality ratio in the United States has more than doubled since 1990, reaching 21-22 per 100,000 live births in 2014. Much has been written over the years about the ‘weekend effect’ as the phenomenon is known amongst obstetricians. Lead researcher Dr. Amirhossein Moaddab commented:

“We were interested in this study because we believe this data provides a valuable window into the problems with the US system of obstetric care delivery.”

The researchers wanted to know if maternal and foetal death figures were higher on weekends versus weekdays or during different months of the year. They analysed more than 45 million pregnancies between 2004 and 2014 to examine if there are significant differences in ratios of both maternal deaths and stillborn deliveries depending on the day they occurred. Lead author Dr. Steven Clark said:

“We were able to control for pregnancy complications, and found that most women with pregnancy complications known to lead to death actually deliver on weekdays, suggesting that the actual problem with weekend deliveries is even greater.”

Weekend delivery is associated with maternal and neonatal deaths, increased ratios of perineal cuts and tears, maternal transfusions, neonatal intensive care admissions, immediate neonatal ventilation requirements, neonatal seizures and antibiotic use.

Researchers also looked at months of the year including the ‘July phenomenon’ – the month of the year that is associated with an increased risk of medical errors and surgical complications that occur in association with the time of year in which medical school graduates begin their residencies. However, the study found no association between maternal-foetal mortality and the month in question. Dr. Clark continued:

“Any system that shows this sort of variation in the most important of all system outcomes is, by definition, badly broken. Our data suggest that a part of the overall dismal US obstetric performance may be related to this systems issue, that is, there may be a ‘spill over’ effect that is demonstrably worse on weekends but is also present on weekdays to a lesser extent.

Our data does not allow us to go any further than this in terms of specifying what the problem is. However, we believe it is likely due to the fact that rarely is care of the pregnant inpatient the primary concern of the treating doctor – it is almost always a distraction from office, surgery or personal activities.”

Hmm, strong words. Did you feel like you were a ‘distraction’ to your doctor? Do you think the day of the week or month of the year you give birth makes a difference to how you are treated in the Irish maternity system?

Let us know your thoughts in the Facebook comments or join the conversation on Twitter @HerFamilydotie

Topics:

new study