ArticleBMJ quality & safety2017
A 'busy day' effect on perinatal complications of delivery on weekends: a retrospective cohort study.
Article in BMJ quality & safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- The effect of nighttime or weekend births on perinatal outcomes in Africa, 2025: Systematic review and meta-analysis.Maternal health, neonatology and perinatology · 2026Review
- Risk of unexpected newborn complications by day of the week and time of birth in US term singleton births.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Association of weekend delivery and perinatal outcomes following cesarean delivery: a retrospective analysis of a multicenter prospective cohort study in China.BMC pregnancy and childbirth · 2026Observational
- The relationship between crowding in the delivery ward and the risk of postpartum hemorrhage.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Effect of delivery hospital busyness on early mortality in small preterm infants: a Finnish population-based cohort study in 2006-2016.BMJ open · 2025Article
- Capacity Planning (Capital, Staff and Costs) of Inpatient Maternity Services: Pitfalls for the Unwary.International journal of environmental research and public health · 2025Article
- What Is the Most Dangerous Time of Birth for Uncomplicated First-Time Mothers and Their Neonates in a Tertiary Obstetric Center?Journal of pregnancy · 2025Article
- Negative spillover due to constraints on care delivery: a potential source of bias in pragmatic clinical trials.Trials · 2024Article
- Association between Delivery during Off-Hours and the Risk of Severe Maternal Morbidity: A Nationwide Population-Based Cohort Study.Journal of clinical medicine · 2023Article
- Associations between unit workloads and outcomes of first extubation attempts in extremely premature infants below a gestational age of 26 weeks.Frontiers in pediatrics · 2023Article
- Busy day effect on the use of obstetrical interventions and epidural analgesia during labour: a cross-sectional register study of 601 247 deliveries.BMC pregnancy and childbirth · 2022Article
- Does high workload reduce the quality of healthcare? Evidence from rural Senegal.Journal of health economics · 2022Article
- Birth during on-call period: Impact of care organization on mortality and morbidity of very premature neonates.Frontiers in pediatrics · 2022Article
- Impact of childbirth policy changes on obstetric workload over a 13-year period in a regional referral center in China - implications on service provision planning.BMC pregnancy and childbirth · 2021Article
- [Association between time of birth and resuscitation outcomes in extremely preterm infants].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- Busy day effect on intrapartum adverse maternal outcomes - a population-based study of 601 247 singleton deliveries.BMC pregnancy and childbirth · 2021Article
- Weekend and off-hour effects on the incidence of cerebral palsy: contribution of consolidated perinatal care.Environmental health and preventive medicine · 2020Article
- Article
- Foetal Morbidity Depending on the Day and Time of Delivery.Geburtshilfe und Frauenheilkunde · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo evaluate whether busy days on a labour and delivery unit are associated with maternal and neonatal complications of childbirth in California hospitals, accounting for weekday/weekend births.
designThis is a population-based retrospective cohort study.
settingLinked vital statistics/patient discharge data for California births between 2009 and 2010 from the Office of Statewide Health Planning and Development.
participantsAll singleton, cephalic, non-anomalous California births between 2009 and 2010 (N=724 967). MAIN OUTCOMES: The key exposure was high daily obstetric volume, defined as giving birth on a day when the number of births exceeded the hospital-specific 75th percentile of daily delivery volume. Outcomes were a range of maternal and neonatal complications.
resultsSeveral maternal and neonatal complications were increased on high-volume days and weekends following adjustment for maternal demographics, annual hospital birth volume and teaching hospital status. For example, compared with low-volume weekdays, the odds of Apgar <7 on low-volume weekend days and high-volume weekend days were 11% (adjusted OR (aOR) 1.11, CI 1.03 to 1.21) and 29% higher (aOR 1.29, CI 1.10 to 1.52), respectively. High volume was associated with increased odds of neonatal seizures on weekdays (aOR 1.33, CI 1.01 to 1.71) and haemorrhage on weekends (aOR 1.11, CI 1.01 to 1.22). After accounting for between-hospital variation, weekend delivery remained significantly associated with increased odds of Apgar score <7, neonatal intensive care unit admission, prolonged maternal length of stay and the odds of neonatal seizures remained increased on high-volume weekdays.
conclusionsOur findings suggest that weekend delivery is a consistent risk factor for a range of perinatal complications and there may be variability in how well hospitals handle surges in volume.
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