Babies born at the weekend at higher risk of complications

The study showed that the rate of perinatal (stillborn or within seven days) death on weekdays was 6.5 per thousand babies delivered.

Published in the British Medical Journal yesterday, the study was based on an analysis of 1.3million births in English hospitals between April 2010 and March 2012.

Previous studies have identified a higher risk of death in patients admitted to hospital on weekends (compared with weekdays) across a range of conditions – a phenomenon termed the “weekend effect”.

The lead researcher Professor Will Palmer explained that the higher death rate and the increased frequency of the problems during weekends were concerning facts that required further investigation in order to help provide newborns that arrive during the weekends with equal chances of survival.

Therefore, medics in the NHS are likely to find they are working more weekends without the extra pay they get under existing contracts.

More research is needed in obstetrics to explore capacity strain and identify effective strategies to safeguard maternal and infant outcomes during such vulnerable times, they write.

Researchers at Imperial College, London also found babies born at weekends were more likely to be readmitted to hospital in an emergency.

Perinatal death rates in the first seven days after birth were highest on Thursday, followed by Saturday and Sunday, when fewer babies are delivered, while the lowest rate of perinatal death was on a Tuesday, the study found.

The largest effects were seen in the higher rates of death among babies, either as a stillbirth or death within the first seven days of birth (7% higher than weekdays), infections after childbirth (6% higher) and the baby suffering an injury during childbirth (6% higher).

However, there was no consistent link between outcomes and staffing levels on wards. The researchers noted that the mortality rate was low, considering that the number of deaths per year averaged 4,500 from 675,000 births.

David Richmond, president of the Royal College of Obstetricians & Gynaecologists, said: “Appropriate numbers of maternity staff underpin a safe and quality service and adequate “out-of-hours” senior staffing remains a key issue in maternity care”.

The authors stress that this is an observational study so no definitive conclusions can be drawn about cause and effect, and say several factors not accounted for may have influenced the findings.

And if infection risk was the same for mothers who delivered on weekends as on weekdays, there would be 470 fewer infections a year, they added.

The Health Minister Ben Gummer has reacted to the latest study and has asked for further evidence of the hospitals’ delivery of the uniform standards of care throughout the week. “Midwives work across 24 hours, 365 days per year”. “However, even after making these adjustments, we found the rates of complications vary on different days”.