City Research Online

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
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:
[thumbnail of e067630.full.pdf]
Preview
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

Download (567kB) | Preview
[thumbnail of Neonatal mortality by time and day of birth - Revision v1.7 clean.pdf] Text - Accepted Version
This document is not freely accessible due to copyright restrictions.
Available under License Creative Commons: Attribution International Public License 4.0.

Export

Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email

Downloads

Downloads per month over past year

Loading...

View more statistics

Actions (login required)

Admin Login Admin Login