Implications of time of day and day of the week for the outcome of birth

我们团队中的一个人从20世纪70年代开始参与了一项研究，研究表明，婴儿的出生在一周中的几天里分布不均。我们之前的项目名为“出生时间”，分析了2005-2014年间英格兰和威尔士700多万名新生儿的出生情况，这是第一个全国性的关于出生日期和出生时间的研究，这项新的建议将建立在这项工作的基础上。我们的研究团队将三大组常规收集的数据结合在一起，将三个来源的母婴记录结合在一起。这些是出生登记、当NHS号码分配给婴儿时的出生通知，以及关于分娩和分娩期间产妇护理的记录。创建了一个数据库，使我们能够分析这些数据。我们的结果显示了一个有规律的每周周期，从周一到周五，出生人数每天都在增加，周六出生人数较少，周日出生人数最低。在圣诞节出生的婴儿最少。出生人数也有季节性变化，在9月下旬达到高峰。当分娩不涉及医疗辅助时，分娩数量在午夜到早上7点最高，在凌晨4点到6点达到顶峰白天是最低的，直到午夜是最低的。计划中的剖腹产通常在工作日的早上进行。引产后的分娩更有可能发生在周二至周六的午夜左右，无论是否需要任何医疗援助，高峰出现在公共假期之前。由于不同地点和出生类型的分娩时间的差异对助产和医疗人员配备以及更广泛的产妇保健组织有影响，因此需要进一步研究，以使用新的数据库来调查影响。因此，我们建议进行研究，以调查儿童及其母亲出生时的死亡率是否会因一天中的时间和一周中的一天而变化。此外，我们希望分析严重并发症发生率的变化。我们计划超越简单的时间细分，在“正常工作时间”内外分析白天和晚上不同时间的结果。由于有迹象表明，一些分娩被提前到周末和公众假期之前，我们计划分析这些选择过程的影响。此外，我们还知道，计划剖腹产率和引产率在不同的分娩单位之间差异很大，这种差异的程度并不能用生育妇女群体的差异来解释。研究表明，这些差异反映了产科医生和助产士政策的差异。因此，我们计划观察出生时间在不同单位之间的差异，以及它们是否似乎与这些政策上的差异有关。

One of our team had been involved in research from the 1970s onwards which showed that the birth of babies was spread unevenly through the days of the week. Our previous project, known as 'Birth Timing', which analysed over seven million births in England and Wales from 2005-2014, was the first national study of both the day and time of births and this new proposal will build on this work.Our research team linked three large sets of routinely collected data to combine mother and baby records from three sources. These were birth registration, birth notification when NHS numbers are allocated to babies, and records about maternity care during labour and birth. A database was created to enable us to analyse the data. Our results showed a regular weekly cycle with numbers of births increasing each day from Mondays to Fridays, lower numbers of births on Saturdays and lowest weekly numbers of births on Sundays. Fewest births occurred at Christmas. Births also varied seasonally, with a peak in late September. When labour involved no medical assistance, numbers of births were highest from midnight to 7am, peaking from 4am to 6am. They were lowest during the day and the hours up to midnight. Planned caesarean births were usually on weekday mornings. Births after induced labour were more likely to occur around midnight on Tuesdays to Saturdays, whether or not any medical assistance was needed, with a peak before public holidays.As the variation in the timing of births by place and type of birth has implications for midwifery and medical staffing and for the organisation of maternity care more generally, further research is needed to use the new database to investigate the implications. We therefore propose research to investigate whether death rates at birth of children and their mothers and varies according to the time of day and day of the week. In addition, we hope to analyse variations in the rates of serious complications. We plan to move beyond the simple subdivision into time inside and outside 'normal working hours' and analyse outcomes at different times of day and night. Asthere are signs that some births are brought forward so that they occur before weekends and public holidays, we plan to analyse the implications of these selection processes.It is also known that rates of planned caesareans and induced labours vary widely between maternity units and the extent of these variations is not explained by differences in the groups of women giving birth. The suggestion is that these differences reflect differences in obstetricians' and midwives' policies. We therefore plan to see how times of birth vary between units and whether they appear to be associated with these differences in policies.