Doctors today warned that pregnant women may be delaying vital checks because of “potentially misleading” claims about more baby deaths at the weekend.
They said the Imperial College research had created “fear and panic” among expectant mothers, with some asking not to be admitted for induction or delivery on Saturday or Sunday, and called for it to be withdrawn.
More than 20 clinicians at Imperial College Healthcare Trust, the college’s NHS partner, have complained to the British Medical Journal about the research. Complaints have also been made by doctors at Barnet and Hillingdon hospitals, with one describing the research as “scaremongering”.
The Royal College of Obstetricians and Gynaecologists said the paper contained “misleading evidence” that would “unnecessarily undermine the public’s confidence in maternity services” and could confuse efforts to improve safety.
The study, which attracted front-page headlines after being published by the BMJ last month, claimed there was a “highly statistically significant increase” in baby deaths at the weekend. It said the “weekend effect” meant there were approximately 770 deaths a year “above what might be expected” if performance were consistent throughout the week.
Obstetricians at Imperial College Healthcare, which runs maternity units at Queen Charlotte’s and St Mary’s hospitals, said some women had asked not to have their babies at the weekend.
They said the research showed that death rates were in fact slightly lower on a Monday and Tuesday and similar from Wednesday to Sunday. In a letter to the Standard, Christoph Lees and Sana Usman said: “It does not mean that entering a hospital on a Thursday or a Saturday puts you at higher risk of your baby dying.”
They said there were “good reasons why delivery at a weekend may actually be safer than during the week”. Women diagnosed with stillbirths during the week may be admitted at the weekend, when it is quieter, to deliver the child. Planned caesareans happen during the week, which may make weekdays appear “safer”.
Hospitals such as Queen Charlotte’s already offer a seven-day service. Dr Kelly Harvey-Jones, a neonatal registrar at Queen Charlotte’s, said: “What these women have to do is put their trust back in the doctors and midwives who have been looking after them throughout their pregnancy. We are there seven days a week, 24 hours a day. If we need to escalate their care, it doesn’t matter what time of the day it is.”
According to the Office for National Statistics, about one in 200 babies is stillborn. Babies born to teenagers or mothers over 45, or to women who smoke or are obese, at greatest risk. Some 57 per cent of neonatal deaths are of premature babies, while 28 per cent had congenital abnormalities.
Professor Paul Aylin, lead author of the Imperial College research, said: “We stand by the paper. We are highlighting a real issue. We are not saying that all of these deaths or maternal infections or injuries to neonates are avoidable, not by any means. All we have done is highlight some variations over seven indicators. Four of the seven appear to be higher at the weekend.”
Dr Fiona Godlee, the BMJ’s editor in chief, said: “The study has contributed to the debate on this controversial and topical issue. We welcome comment from all sides.”
- An edited version of this article appears in tonight’s Evening Standard.