Did you know that maternal mortality rates have more than doubled since 1990? A recent study (presented at a conference in Las Vegas and soon to be published) looks at the rates of weekend deliveries and the increased risk of maternal death. Steven Reinberg, HealthDay Reporter with US News & World Report summarizes the study:
For the study, researchers reviewed outcomes from more than 45 million pregnancies in the United States between 2004 and 2014. They found a slightly increased risk of death among mothers who delivered over the weekend — about 21 per 100,000 deliveries, compared with about 15 per 100,000 during the week.
The Baylor researchers also found that weekend deliveries were linked to the need for more maternal blood transfusions and more tearing in the area between the vagina and anus (perineum). In addition, neonatal intensive care unit admissions, neonatal seizures and antibiotic use all rose on weekends, compared with other times of the week, the study reported.
“There is clearly something different about the health care offered to women on the weekends,” Clark said.
Although the exact reasons for this weekend effect aren’t known, several factors may be in play, he speculated.
“It may be that there are less experienced people on weekend shifts,” Clark said. “That’s commonly seen in nursing and physician staffing. It may also be that people on those shifts are tired.”
Or, it may be that doctors are distracted, Clark said. “They may not be focused on patient care, but rather other things they want to do on the weekend,” he said. “Our data does not allow us to say which of these things is linked to worse care.”
Something about weekend care appears to need changing, Clark said. But because the reasons for these problems aren’t known, the changes needed aren’t clear, he said.
Dr. Mitchell Kramer, chairman of the department of obstetrics and gynecology at Northwell Health’s Huntington Hospital in Huntington, N.Y., questioned the study’s findings.
“They are grasping at straws to explain why infant and maternal mortality rates increase on weekends,” Kramer said. “I think it’s more complex than what they say.”
Kramer said he found the notion that doctors are distracted and patients fare worse over the weekend “disturbing and insulting. That comment alone makes me very dubious about the results of this study,” he said.
“In my hospital, patients get the same care on weekends that they get during the week,” he said.
Clark, however, sees the weekend effect as one possible reason for the overall higher maternal mortality in the United States, compared with other countries.