Neonatal mortality in NHS maternity units by timing and mode of birth: a retrospective linked cohort study
Carty, L., Grollman, C. ORCID: 0000-0002-6950-1837, Plachcinski, R. ORCID: 0000-0001-9908-0773 (2023). Neonatal mortality in NHS maternity units by timing and mode of birth: a retrospective linked cohort study. BMJ Open, 13(6), article number e067630. doi: 10.1136/bmjopen-2022-067630
Abstract
Objectives: To compare neonatal mortality in English hospitals by time of day and day of the week according to care pathway.
Design: Retrospective cohort linking birth registration, birth notification and hospital episode data
Setting: NHS hospitals in England
Participants: 6,054,536 liveborn singleton births from 2005 to 2014 in NHS maternity units in England
Main outcome measures: Neonatal mortality
Results: After adjustment for confounders, there was no significant difference in the odds of neonatal mortality attributed to asphyxia, anoxia or trauma outside of working hours compared with working hours for spontaneous births or instrumental births. Stratification of emergency caesareans by onset of labour showed no difference in mortality by birth timing for emergency caesareans with spontaneous or induced onset of labour. Higher odds of neonatal mortality attributed to asphyxia, anoxia or trauma out of hours for emergency caesareans without labour translated to a small absolute difference in mortality risk.
Conclusions: The apparent ‘weekend effect’ may result from deaths among the relatively small numbers of babies who were coded as born by emergency caesarean section without labour outside normal working hours. Further research should investigate the potential contribution of care-seeking and community-based factors as well as the adequacy of staffing for managing these relatively unusual emergencies.
Publication Type: | Article |
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Additional Information: | This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RG Gynecology and obstetrics |
Departments: | School of Health & Psychological Sciences > Midwifery & Radiography |
SWORD Depositor: |
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