Study suggests it’s safe to give birth outside working hours in the UK

Between 2005 and 2014, almost all births in the UK were associated with anoxia (lack of oxygen) and trauma, even those born outside working hours compared to those born outside working hours, according to a new study. There was no significant increase in the risk of infant mortality due to working time.

The findings run counter to the widespread ‘weekend effect’ assumed in previously reported studies that suggested a significantly higher risk of death for those who gave birth after working hours or on weekends.

The new study, from City University of London, combined large amounts of data from health services and official statistics on more than 6 million births over a decade.

This allowed researchers to stratify by how labor began (“spontaneous,” induced labor, or no labor) and type of birth (“spontaneous,” caesarean section, or forceps or ventilator-assisted delivery). I was able to analyze childbirth in detail, including fertility. ), time of day, birth date, and obstetric risk factors.

Importantly, stillbirths (prenatal deaths) were excluded from the analysis in this study. More than 90 percent of stillbirths are known to occur before the onset of labour, so they are unlikely to be affected by care during delivery. In most of the remaining cases, it is unclear whether the stillbirth occurred before or during delivery.

Stillbirth was included in a previously published study of 1.3 million births in the United Kingdom, but this study focused on the day of the week rather than the time of birth and determined whether stillbirth, death during pregnancy, or death occurred. concluded that the proportion of Weekends were higher in the first week of life.

A previous study of over 1 million live births in Scotland excluded stillbirths and included birth time in the analysis of deaths within the first month of life. The report concluded that after-hours mortality on weekdays was higher during off-hours.

However, none of these studies provide enough detail to identify the small subgroup of births found in the current study of births in the UK that are at higher risk of infant mortality. It wasn’t the scale.

Current research shows that in 2% of UK births (emergency caesarean births without delivery), babies born outside of working hours are at greater risk of dying from hypoxia (lack of oxygen) and trauma during delivery. was found to be 1.5 times higher than Childbirth during working hours. Because neonatal death is a rare event, this high relative risk translates into a low absolute risk (an estimated 46 neonates died over the 10-year study period).

Based on this evidence, the study recommends that attempts to reduce risk should focus on this small subset of emergency births, rather than viewing all after-hours births as risky. The report aims to understand who gives birth by painless emergency caesarean delivery and what aspects of community and hospital care can help prevent serious accidents from occurring. It suggests that further research should be focused on. Such aspects of care may include prenatal monitoring and advice on medical-seeking behavior, especially for vulnerable mothers and babies.

The authors acknowledge that their study did not examine birth data from 2015 to the present. However, these data have not yet been linked and made available. This means that an analysis of this period, including the worsening understaffing of maternity services and the impact of the COVID-19 pandemic, is beyond the scope of this study. They continue to seek funding to acquire and analyze these data in future studies.

Allison McFarlane, principal investigator of the study and Professor of Midwifery and Radiology, City University of London, said:

“These findings are very encouraging and demonstrate the benefits of using very large linked datasets. It shows that attention should be shifted to identifying smaller subgroups and identifying the necessary measures to meet their needs.”

This article appears online in the journal BMJOpen.

/ Open to the public. This material from the original organization/author may be of the nature of its time and has been edited for clarity, style and length. Mirage.News does not take any organizational positions or positions and all views, positions and conclusions expressed herein are those of the authors only. Read the full article here.

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