Is giving birth on the weekend riskier?


Giving birth on the weekend may be riskier for moms and newborns, a new study out of England suggests.

The "weekend effect" in hospitals -- which suggests patients experience worse medical outcomes on weekends -- is understudied when it comes to obstetric care, and the results are mixed, said Dr. Aaron Caughey, professor and chair of the Department of Obstetrics and Gynecology at Oregon Health & Science University. Caughey is also the co-author of an accompanying editorial in The British Medical Journal.

The observational study included analysis of medical records on more than 1.3 million deliveries and births between April 2010 and March 2012, looking at outcomes for mothers and newborns. The authors tracked the number of deaths for both babies and mothers, as well as infections, emergency readmissions, and injuries. All of the births had taken place at English National Health Service hospitals.

A mother's age, ethnic group, socioeconomic status, previous caesarean sections, and any existing conditions such as diabetes or high blood pressure were taken into account. Hospital staffing factors were also investigated.

The study, by scientists at Imperial College London, found that there was a slight increase in adverse outcomes when women gave birth on the weekend, specifically a rise in stillbirths and deaths. The risk for nighttime deliveries was even higher.

The researchers wrote that "the results would suggest approximately 770 perinatal deaths and 470 maternal infections per year above what might be expected" from weekday births.

The editorial authors noted that the difference was not large, but it's important because the consequences to mothers and babies could be so serious. "Although the magnitude was small, the gravity of this outcome demands our attention," they wrote.

Given the decreased levels of staffing and availability of resources that may be a fact of life at some hospitals on the weekend, the findings are not surprising, Caughey told CBS News. But it's unclear how the findings from England would translate to the U.S. hospital system, he added.

The study showed no significant link between birth outcomes and staffing issues, but the authors noted that more research is needed in this area and stressed that because the study is observational, no definitive conclusions can be drawn about cause and effect.

It's possible weekday deliveries are lower risk because more are scheduled, added Caughey, who is also a spokesperson for the American Congress of Obstetricians and Gynecologists. He also said more studies need to be conducted to explore the apparent protective effect of weekday deliveries, and to ensure that women who deliver on the weekend, and their babies, receive the same benefits.

He said unlike the more uniform English hospital system, in the U.S., "there are a vast number of health systems" which makes it more challenging to study birth trends across the country. However, a study of California hospitals by Caughey and colleagues (published in Obstetrics and Gynecology in 2013) showed that on busier, high-volume weekend days, there was a higher risk of death among newborns and a lower rate of cesarean deliveries.

The editorial authors also noted that "evidence is emerging that other factors related to capacity strain such as busy days, holidays, and doctors' absence at conferences affect patients' outcomes, in addition to weekend effects."

"I don't think that these findings should lead women having a baby to increase interventions to attempt to have a delivery on a weekday. We simply do not fully understand how such interventions might interfere with the normal course of labor and delivery. If you are nervous, I would have a conversation with your prenatal care provider," said Caughey.

"In my experience, the full range of hospitals in the U.S. have the capability to call in more staff when things get busy on the weekend," he added.

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