Weekend Births May Be Riskier
The More Babies Delivered at a Hospital, the Lower the Risk, Researchers Report
May 8, 2007 -- Giving birth on a weekend may be riskier to a newborn's life if relatively few babies are delivered at the hospital, according to a new Texas study.
"Overall, we found a 'weekend effect' in all but the largest volume of hospitals," says Elizabeth Restrepo, PhD, RN, a clinical consultant and data analyst at Texas Health Resources in Arlington. She presented the findings Tuesday at the 55th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in San Diego.
Researchers found that the greater the number of babies delivered at a hospital, the lower the risk of death during the neonatal period, the first 27 days.
Risk Lowers With Volume
Restrepo and her co-author, Patti Hamilton, RN, a professor of nursing at Texas Woman's University in Denton, looked at birth and death certificates in Texas for three years: 1999, 2000, and 2001. They looked at more than a million births.
They classified the hospital at which the baby was born by volume, depending on how many babies were delivered there during the three-year period.
Category 1, with the least volume, included hospitals at which one to 3,971 infants were delivered during the three-year period. Category 2 hospitals delivered 3,972 to 7,708 babies; category 3, 7,709 to 13,976; and category 4 delivered 13,977 or more babies.
When the researchers adjusted for other factors that can increase the risk of newborn death, such as low birth weight, the increased risk associated with hospital birth volume still held only for those that delivered next to the fewest number of babies.
Those babies born in the category 2 hospitals had a 51% greater risk of death if born on a weekend than on a weekday, Restrepo tells WebMD.
Interpreting the Study and the Issue
Why did the smallest-volume hospitals not carry an increased weekend risk? "In small volume hospitals, a baby is likely to be airlifted to a higher level of care [if needed]," Restrepo says.
The so-called weekend effect on newborns, as well as adults undergoing surgeries, has been debated for years, Restrepo says. It is believed to be due to reduced staffing.