Objective To characterise the association between weekend (Saturday and Sunday) deliveries of very low birthweight (VLBW) infants and delivery room outcomes in the ‘golden hour’ after birth.
Design and setting A retrospective cohort study using California Perinatal Quality Care Collaborative data from participating neonatal intensive care units.
Patients The study population after exclusions was 26 515 VLBW infants born in California from 2010 to 2016.
Main outcome measures Delivery room outcomes assessed included: chest compressions, epinephrine, intubation prior to continuous positive airway pressure ventilation, 5 min Apgar <4, admission hypothermia and death within 12 hours. To adjust for potential confounders, we fit multivariate regression models controlling for two sets of infant, maternal and hospital characteristics.
Results Infants delivered on weekends were less likely to have been prenatally diagnosed with intrauterine growth restriction but were otherwise not significantly different in gestational age, ethnicity, sex or maternal risk factors than those born during weekdays. Caesarean deliveries were less common on weekends, while vaginal deliveries were consistent across all days. After adjusting for sex and race, weekend delivery was associated with delivery room chest compressions (OR: 1.12, 95% CI 1.02 to 1.24) and lower 5 min Apgar (OR: 1.11, 95% CI 1.01 to 1.21).
Conclusion In this population-based study of VLBW infants, there was an increase in chest compressions for infants born on the weekend. More research is needed on the differences between populations born on weekdays versus weekends, and how these may contribute to observed associations.
- health services research
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Contributors EHC conceptualised and designed the study, carried out the analysis, drafted initial manuscript and reviewed and revised the manuscript. HL conceptualised and designed the study, assisted with data management and analysis, and reviewed and revised the manuscript. WL conceptualised and designed the study and critically reviewed the manuscript. JMS conceptualised and designed the study, supervised data analysis and critically reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding All phases of this study were supported by The Pratt Family Foundation (to EHC). JMS is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number R00 HD079658-03).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available. Data are available with a collaboration agreement with the California Perinatal Quality Care Collaborative (contact firstname.lastname@example.org).
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