Frontiers in medicine · 2026
Impact of scheduled cesarean sections on non-working days on maternal and neonatal outcomes: a retrospective cohort study based on propensity score matching.
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Tan Ting Fang, Wei Qing Fang, Huang Jian Chun, Zhao Kai Sun
Аннотация
OBJECTIVE: This study aimed to investigate the impact of performing scheduled cesarean sections for term singleton pregnancies on working versus non-working days on maternal and neonatal outcomes.
METHODS: This retrospective study included women who underwent scheduled cesarean sections for term singleton pregnancies at our hospital between January and December 2024. Participants were divided into working-day and non-working-day groups based on the date of surgery. Propensity score matching (PSM) (1:1 nearest neighbor matching, caliper width 0.2 times the propensity score standard deviation) balanced confounding factors, including maternal age, gestational age, parity, prior cesarean deliveries, conception method, hypertensive disorders, gestational diabetes, and pre-pregnancy body mass index (BMI). After matching, we compared postoperative fever, neonatal transfer, surgery-related outcomes, and umbilical cord blood gas parameters between the groups. Multivariable linear regression analysis was additionally performed to adjust for residual confounding. Staffing configurations for obstetrics, anesthesia, neonatology, and nursing during working and non-working days are detailed in the Methods section.
RESULTS: Among the 300 women enrolled, 100 remained in each group after matching (all standardized mean differences <0.1). Matched analysis revealed no significant between-group differences in postoperative fever, neonatal transfer, surgical blood loss, postoperative hospital stay, antibiotic duration, or umbilical cord pH and lactate levels (p > 0.05). Multivariable regression analysis showed that surgery on non-working days was independently associated with a shorter operative duration (β = -3.82, 95% CI: -7.22 to -0.42, p = 0.029), without significant differences in other outcomes.
CONCLUSION: In this single-center setting with standardized staffing, no statistically significant differences in short-term adverse maternal or neonatal outcomes were detected between scheduled cesarean sections performed on working and non-working days in this study population and based on the available sample size.
METHODS: This retrospective study included women who underwent scheduled cesarean sections for term singleton pregnancies at our hospital between January and December 2024. Participants were divided into working-day and non-working-day groups based on the date of surgery. Propensity score matching (PSM) (1:1 nearest neighbor matching, caliper width 0.2 times the propensity score standard deviation) balanced confounding factors, including maternal age, gestational age, parity, prior cesarean deliveries, conception method, hypertensive disorders, gestational diabetes, and pre-pregnancy body mass index (BMI). After matching, we compared postoperative fever, neonatal transfer, surgery-related outcomes, and umbilical cord blood gas parameters between the groups. Multivariable linear regression analysis was additionally performed to adjust for residual confounding. Staffing configurations for obstetrics, anesthesia, neonatology, and nursing during working and non-working days are detailed in the Methods section.
RESULTS: Among the 300 women enrolled, 100 remained in each group after matching (all standardized mean differences <0.1). Matched analysis revealed no significant between-group differences in postoperative fever, neonatal transfer, surgical blood loss, postoperative hospital stay, antibiotic duration, or umbilical cord pH and lactate levels (p > 0.05). Multivariable regression analysis showed that surgery on non-working days was independently associated with a shorter operative duration (β = -3.82, 95% CI: -7.22 to -0.42, p = 0.029), without significant differences in other outcomes.
CONCLUSION: In this single-center setting with standardized staffing, no statistically significant differences in short-term adverse maternal or neonatal outcomes were detected between scheduled cesarean sections performed on working and non-working days in this study population and based on the available sample size.