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Birth Injuries: The weekend effect

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    This seventh blog in our series of blogs relating to injuries suffered around the time of birth, considers recent news reports which suggest that there may be a greater likelihood of mothers and babies suffering injuries if they are born at the weekend.

    By Abigail Ringer

In December 2015 there were numerous reports of a study published by Imperial College London which concluded that babies born at the weekend have a slightly higher risk of death or injury than those who were born Monday to Friday.

Researchers at Imperial College London, looked at over one million births in England between 1 April 2010 and 31 March 2012 and found that the number of babies who died within the first 7 days of life, or suffered injury, was higher for babies born over the weekend than for those born Monday to Friday.

The results of the study, published by the British Medical Journal, concluded that for babies born during the week, 14.5 babies in every thousand suffered injury, whilst for those born at the weekend, the number had risen to 15.3 babies in every thousand. The days that had the lowest rate of injury to the baby during birth were Wednesday and Thursday.  Please see my colleague Hannah’s previous blog which looked into this research in more detail.

In response to this I undertook my own, smaller scale study to see whether the ‘weekend effect’ extends to my experience of representing the families of children whose births have been complicated by injury. This blog describes the results.

Method

All of the children in the sample have suffered from birth injuries and I set out to find out what percentage of these children were born at the weekend. All things being equal, as Saturdays and Sundays make up two of the seven days in the week, one would expect the number of children to have been born at the weekend who have suffered injury to also be 2/7s (or 29%). If, however, the percentage was greater than 29%, this would be consistent with the conclusions reached by the study from Imperial College i.e. that the rate of birth injury is higher at the weekends than during the week.

Results

Taking 17 children at random, all of whom had suffered birth injury of some kind, 7 of them were born on a Saturday or a Sunday. This represents 41% of all the children within the sample and is significantly higher than the average of 29% that would be expected if the ‘weekend effect’ did not exist. Although my study has the limitations of a rather small sample size, it does accord with the findings of the researchers at Imperial College. What’s more, the number of children within the group who were born on a Wednesday and Thursday made up just 12%.

Conclusion

I do not believe the cause of the reported ‘weekend effect’ is fully understood. One explanation may be the availability of senior staff at the weekend, but the study found no significant association between consultant staffing levels and complications causing injury or death. The larger study did not, however, look at the levels of other staffing within the maternity units. Another possible explanation would be that a smaller proportion of elective admissions take place over the weekend, with Saturday and Sunday taking a proportionately higher percentage of emergency admissions. I hope that the mystery of the ‘weekend effect’ is soon resolved, and will be following any further reports with interest.

In the next blog in our series, Simon will be answering some ‘frequently asked questions’ from parents of children who have suffered brain injury around the time of their birth in relation to the legal process for making a claim.

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