Risks of Stillbirth and Early Neonatal Death by Day of Week
Bibliographic record
Abstract
Unless labor is timed for high-risk pregnancies or there are differences in the quality of perinatal care, births on different days of the week should have similar outcomes. Not many such studies have been done, but all of them point to a higher risk of stillbirth and/or early neonatal death for infants born on weekend days rather than on weekdays. The investigators, using a Canadian database of 3,239,972 births taking place in the years 1985 through 1998, sought associations between these outcomes and the day of the week at birth. These women represented all births recorded in Canada during the period under review except for Ontario. Births were 24% less frequent on weekend days than during the week. Stillbirth rates were lowest on Mondays and highest on Saturdays. Neonatal deaths were considerably more frequent among infants born on Saturdays and Sundays (Fig. 1), particularly those caused by asphyxia. These patterns were consistent throughout the review period. Cause-specific excess risks for stillbirth varied widely. Stillbirths resulting from congenital anomalies were much less frequent on weekend days than on weekdays. Cause-specific excess risks for early neonatal death also varied widely, ranging from +28% for asphyxia and immaturity to −3% for congenital anomalies. On logistic regression analysis, controlling for completed weeks of gestational age, there was no apparent excess risk of either stillbirth or early neonatal death on weekends. For preterm infants, the gestational age-specific risks of early neonatal death were similar or slightly lower for infants born on weekend days.Fig. 1: Early neonatal death rates (overall and resulting from asphyxia) by day of week at birth. Error bars represent 95% confidence intervals. Risks of stillbirth and early neonatal death by day of week. Reprinted with permission from CMAJ 2004;170: 337–341. Copyright © Canadian Medical Association, 2004. All rights reserved.Any excess risk of stillbirth or early neonatal death on weekend days in this Canadian study was much smaller than has been reported from other countries. The present findings suggest that, in Canada, accessibility to quality obstetric and neonatal care is maintained on weekends.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".