Do babies born at the weekend have higher risk of complications?
来源：未知 作者：贾姑跏 时间：2017-10-05 01:01:21
By Andy Coghlan HOW important is a birthday? Babies born in English hospitals at the weekend have a greater risk of dying than those born on a weekday, suggests an analysis of 1.35 million births. However, when the data is examined by day, the highest risk of death was on Thursday, not Saturday or Sunday. Further work is needed to investigate differences in apparent risk of death, say the study authors. During 2010 to 2012, there were 6.5 newborn deaths per 1000 deliveries during weekdays, compared with 7.1 deaths on a Saturday or Sunday. “In terms of numbers it sounds small, but it is significant,” says lead author William Palmer of Imperial College London. The figures equate to about 770 more deaths per year than if all babies were born on a Tuesday – the day with the lowest death rate. The analysis comes as junior doctors in England voted to strike over changes to their contracts, aimed at increasing the number of staff available at the weekend. Weekend births are not good for mums either. Their rates of infection rose slightly, from 8.2 per 1000 deliveries on a weekday, to 8.7 on a weekend. Mums who gave birth on a Saturday or Sunday were also more likely to have perineal tears – this appeared to be linked to a lack of availability of consultants, says Palmer. Although researchers ruled out a link between other birth complications and consultant shortages, further work is needed to investigate whether staff shortages at other levels may be to blame. “Most care is provided by midwives, but a large amount of work is also provided by junior doctors,” says Palmer. Andrew Whitelaw, emeritus professor of neonatal medicine at the University of Bristol, UK, points out that the study uses a database that contains missing data for some births. “There is an overall increase in perinatal mortality at the weekend,” he says, “but we need much better clinical information to know how much is due to differences in the babies born at weekends and how much to differences in the quality of the clinical care.” Health minister Jeremy Hunt has said that no junior doctor will see a pay cut after their new contracts come into force next year. However, although doctors will see a basic pay increase of 11 per cent, they claim some could be worse off because of proposed cuts to the number of hours classed as unsociable and thus attracting extra pay. For example, junior doctors may receive more money for working unsociable hours under the new contracts, but whereas the whole of a Saturday used to count as unsociable, now that only applies to hours worked after 7pm. The contracts were designed, in part, to make it cheaper to have more doctors working at weekends. Therefore, medics in England are likely to find they are working more weekends without the extra pay they get under existing contracts. Doctors also claim that the contracts remove vital patient safeguards and limit pay progression. The planned strikes are scheduled for 1, 8 and 16 December. Journal reference: BMJ, DOI: 10.1136/bmj.h5774 Image credit: Rune Hellestad/Corbis Correction: