Variations in the number of births by day of the week, and morbidity and mortality in very-low-birth-weight infants
Por:
García-Muñoz F, García-Cruz L, Galán G, Urquía L, Rivero S, García-Alix A and Figueras-Aloy J
Publicada:
1 ene 2019
Ahead of Print:
2 dic 2017
Resumen:
Objective: To know the distribution of births of very low birth weight infants by day of the week, and whether this distribution affects the morbidity and mortality in this group of patients.
Methods: This was a retrospective analysis of data collected prospectively in the Spanish SEN1500 network (2002-2011). Outborn infants, patients with major congenital anomalies, and those who died in the delivery room were excluded. Births were grouped into "weekdays" and "weekends." A multivariate logistic regression analysis was conducted to evaluate the independent effect of the birth moment on outcomes, and Cox regression for survival.
Results: Out of a total of 27,205 very low birth weight infants born at and/or admitted to the participating centers, 22,961 (84.4%) met inclusion criteria. A reduction of 24% in the number of births was observed during the "weekends" compared with "weekdays". In the raw analysis, patients born on weekends exhibited higher morbidity and mortality (mortality rate: 14.2% vs. 16.5%, p < 0.001), but differences were no longer significant after adjusting for confounding factors.
Conclusions: The present results suggest that current care practices reduce the proportion of births during the weekends and tend to cluster some high-risk births during this period, increasing crude morbidity and mortality. However, after adjusting for confounding factors, the differences disappear, suggesting that overall care coverage in these centers is appropriate. (C) 2017 Sociedade Brasiteira de Pediatria. Published by Elsevier Editora Ltda.
Filiaciones:
García-Muñoz F:
Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Unidad Neonatal, Las Palmas, Spain
García-Cruz L:
Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Unidad Neonatal, Las Palmas, Spain
Galán G:
Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Unidad Neonatal, Las Palmas, Spain
Urquía L:
Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Unidad Neonatal, Las Palmas, Spain
Rivero S:
Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria, Unidad Neonatal, Las Palmas, Spain
García-Alix A:
Hospital Sant Joan de Deu, Unitat Neonatal, Barcelona, Spain
Figueras-Aloy J:
Hospital Clinic, Unitat Neonatal, Barcelona, Spain
Green Submitted, Green Published, gold
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