Daytime births are associated with better perinatal outcomes in secondary and tertiary hospitals
Bibliographic record
Abstract
Commentary on: 1. de Graaf JP, 2. Ravelli AC, 3. Visser GH, 4. et al . Increased adverse perinatal outcome of hospital delivery at night. BJOG 2010;117:1098–107. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] It has been shown that very low birthweight newborns have better outcomes in hospitals with a large neonatal intensive care unit.1 The evidence is less clear on the need for large hospitals for low and medium risk births.2 3 There is concern that the lack of availability of experienced staff and supportive facilities during out-of-office hours in non-tertiary hospitals may lead to an increased rate of adverse neonatal outcomes in evenings, nights and weekends. The objective of this study was to evaluate the role of time of birth, volume of the maternity unit and physician staffing in the performance of maternity units. Data were used from the Netherlands Perinatal Register over a period of 7 years on singleton births that started in obstetrician-led care. Analyses were conducted separately for births from 22 weeks gestation in tertiary hospitals (N=108 445) and for births from 32 weeks without congenital abnormalities in non-tertiary hospitals (N=655 961). Time of delivery was divided into day-time (8.00–18.00 h), evening-time (18.00–23.59 h) and night-time (0.00–07.59 h). Based on the results of a maternity unit survey a seniority index variable was constructed for non-tertiary hospitals (number of obstetricians and residents in training divided by the total number of obstetricians, residents in training, residents not in training and clinical midwives). The outcomes were perinatal mortality (intrapartum death or neonatal … [1]: {openurl}?query=rft.jtitle%253DBJOG%2B%253A%2B%2Ban%2Binternational%2Bjournal%2Bof%2Bobstetrics%2Band%2Bgynaecology%26rft.stitle%253DBJOG%26rft.aulast%253Dde%2BGraaf%26rft.auinit1%253DJ.%2BP.%26rft.volume%253D117%26rft.issue%253D9%26rft.spage%253D1098%26rft.epage%253D1107%26rft.atitle%253DIncreased%2Badverse%2Bperinatal%2Boutcome%2Bof%2Bhospital%2Bdelivery%2Bat%2Bnight.%26rft_id%253Dinfo%253Adoi%252F10.1111%252Fj.1471-0528.2010.02611.x%26rft_id%253Dinfo%253Apmid%252F20497413%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1111/j.1471-0528.2010.02611.x&link_type=DOI [3]: /lookup/external-ref?access_num=20497413&link_type=MED&atom=%2Febmed%2F16%2F2%2F59.atom [4]: /lookup/external-ref?access_num=000279532500010&link_type=ISI
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Editorial About the Canadian research system: no · About a Canadian topic: no | Observational | high |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Observational | medium |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".