Evidence map›Paper›PMID 40281529›Full record

ArticleBMC pregnancy and childbirth2025

Associations between nighttime or weekend deliveries and adverse maternal, birth, and neonatal outcomes: secondary analysis of the MANGO study in western Kenya.

Maneet K Virk, Jenine Shafi, Pooja Maheria, Garoma Basha, Harold E Kooreman, John Humphrey, James G Carlucci, Audrey Chepkemoi, Caitlin Bernard, Megan S McHenry and 9 more

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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

19 authors.

Maneet K Virk *University of Washington, Seattle, WA, USA.
Jenine Shafi *University of Washington, Seattle, WA, USA.
Pooja MaheriaUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Garoma BashaUniversity of Washington, Seattle, WA, USA.
Harold E KooremanDepartment of Biostatistics & Health Data Science, School of Medicine, Indiana University, Indianapolis, IN, USA.
John HumphreyDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA.
James G CarlucciDepartment of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, USA.
Audrey ChepkemoiMoi University School of Medicine, Eldoret, Kenya.
Caitlin BernardDepartment of Obstetrics & Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA.
Megan S McHenryDepartment of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, USA.
Beverly MusickDepartment of Biostatistics & Health Data Science, School of Medicine, Indiana University, Indianapolis, IN, USA.
Caroline KerichAcademic Model Providing Access to Healthcare (AMPATH) at Moi Teaching and Referral Hospital, Eldoret, Kenya.
Winnie MatelongAcademic Model Providing Access to Healthcare (AMPATH) at Moi Teaching and Referral Hospital, Eldoret, Kenya.
Constantin T YiannoutsosDepartment of Biostatistics and Health Data Science, R.M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
Wycliffe KosgeiMoi University School of Medicine, Eldoret, Kenya.
Julia SongokMoi University School of Medicine, Eldoret, Kenya.
Kara Wools-KaloustianDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA.
Edwin WereMoi University School of Medicine, Eldoret, Kenya.
Rena C PatelUniversity of Washington, Seattle, WA, USA. renapatel@uabmc.edu.ORCID http://orcid.org/0000-0001-9893-5856

Funding

East Africa International Epidemiology Database to evaluate AIDS (IeDEA) Regional ConsortiumU01AI069911 · NIAID · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI AGGREY SEMWENDERO SEMEERE, Kara Kay Wools-Kaloustian · 2006 to 2026
$57.7M
Developing an enhanced Mentor Mother strategy to improve prevention of mother-to-child transmission of HIV (PMTCT) outcomesK23HD109056 · NICHD · INDIANA UNIVERSITY INDIANAPOLIS · PI JAMES G CARLUCCI · 2022 to 2026
$772k
Adaptation, execution, and evaluation of a differentiated service delivery model for PMTCTK23HD105495 · NICHD · INDIANA UNIVERSITY INDIANAPOLIS · PI HUMPHREY, JOHN M · 2021 to 2025
$722k
Eunice Kennedy Shriver National Institute of Child Health and Human Development K23HD105495Eunice Kennedy Shriver National Institute of Child Health and Human Development K23HD109056NIAID NIH HHS U01 AI069911NICHD NIH HHS K23 HD105495NICHD NIH HHS K23 HD109056NIH HHS U01AI069911
6 · The paper itself

Abstract

backgroundMaternal and neonatal morbidity and mortality remain high in low-income and middle- income countries (LMICs), and staffing schedules may contribute to adverse pregnancy outcomes. Particularly, during the nighttime and on weekends, provider staffing is often limited, which may make it difficult for pregnant persons to receive quality care. We leveraged existing data collected in a pharmacovigilance pregnancy project, named Measuring Adverse Pregnancy and Newborn Congenital Outcomes (MANGO) study, to determine any associations between nighttime/weekend deliveries and adverse (1) maternal, (2) birth, or (3) neonatal outcomes.

methodsWe conducted a secondary analysis of prospective data from the MANGO study, which documents delivery outcomes for pregnant persons at the Moi Teaching and Referral Hospital in western Kenya, from September 2020-November 2023. We utilized multivariable Poisson regression models, with log link, robust standard errors, and adjusted for several covariates, to assess the association between nighttime/weekend deliveries and adverse composite maternal, birth, or neonatal outcomes.

resultsA total of 25,911 neonates born to 25,247 pregnant persons were included. More than half of deliveries occurred during nighttime (6pm to 7am)/weekends (62.6%). In multivariate modeling, nighttime/weekend delivery was associated with a reduced risk of adverse composite maternal outcomes (adjusted risk ratio [aRR] 0.92, 95% confidence interval [CI]: 0.88, 0.96) and composite birth outcomes (aRR 0.92, 95% CI: 0.88, 0.96). No association was found between nighttime/weekend delivery and neonatal death. In post-hoc analyses, weekend deliveries were associated with reduced risk of emergency Caesarean deliveries, preterm birth, and low birth weight. Having advanced maternal age, obstetric complications, and transferring to the hospital for delivery were associated with adverse maternal and birth outcomes. Poor APGAR score was strongly associated with neonatal death.

conclusionsNighttime/weekend deliveries were associated with better maternal and birth outcomes, perhaps due to decreased emergency Caesarean deliveries for high-risk pregnancies or other factors. Greater attention to individual-level factors, such as obstetric complications, may be considered to improve outcomes for pregnant persons and their neonates. Future research may focus on under-resourced, non-tertiary hospitals to offer a more generalizable view of this exposure-outcome relationship in LMICs.

Indexed as

Delivery, ObstetricPregnancy ComplicationsPregnancy OutcomeAdultFemaleHumansInfant, NewbornKenyaPregnancyProspective StudiesTime FactorsYoung AdultAdverse pregnancy outcomesEmergency caesarean deliveryHospital staffingKenyaNeonatal deathNighttime/weekend deliveriesPreterm birth

Identifiers

PMID40281529
PMCPMC12023512

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