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Table 2 The association between nighttime/weekend deliveries and adverse composite maternal outcomes (maternal death, prolonged labor, postpartum hemorrhage, and emergency Cesarean section), MANGO study, September 2020-November 2023 (n = 25,247 pregnant persons)

From: Associations between nighttime or weekend deliveries and adverse maternal, birth, and neonatal outcomes: secondary analysis of the MANGO study in western Kenya

Characteristics

Adverse maternal outcome

No adverse maternal outcome

Unadjusted RR

(95% CI)1

p-value

Adjusted RR

(95% CI)2

p-value

Nighttime/weekend delivery

      

 Yes

3937 (27.81)

10222 (72.19)

0.92 (0.89, 0.96)

< 0.001

0.92 (0.88, 0.96)

< 0.001

 No

2420 (30.05)

5632 (69.95)

Ref.

 

Ref.

 

Maternal age

      

 < 24

1670 (25.83)

4795 (74.17)

0.88 (0.84, 0.93)

< 0.001

0.86 (0.81, 0.91)

< 0.001

 24–35

3850 (29.16)

9353 (70.84)

Ref.

 

Ref.

 

 > 35

831 (33.29)

1665 (66.71)

1.14 (1.07, 1.21)

< 0.001

1.13 (1.06, 1.21)

< 0.001

Parity

      

 0

2449 (27.37)

6500 (72.63)

0.95 (0.90, 0.99)

0.05

1.00 (0.94, 1.05)

0.92

 1

1814 (28.81)

4482 (71.19)

Ref.

 

Ref.

 

 2

1119 (29.77)

2640 (70.23)

1.03 (0.97, 1.10)

0.31

0.98 (0.92, 1.05)

0.59

 3 or more

972 (30.41)

2224 (69.59)

1.05 (0.99, 1.13)

0.104

0.94 (0.87, 1.01)

0.01

Gravidity3

      

 1

2295 (27.17)

6152 (72.83)

0.96 (0.91, 1.01)

0.1

  

 2

1772 (28.41)

4465 (71.59)

Ref.

   

 3

1128 (29.79)

2658 (70.21)

1.04 (0.98, 1.11)

0.14

  

 4 or more

1155 (31.00)

2571 (69.00)

1.08 (1.02, 1.16)

0.006

  

Maternal HIV status

      

 Positive

227 (28.95)

557 (71.05)

1.01 (0.90, 1.13)

0.83

  

 Negative

6130 (28.61)

15297 (71.39)

Ref.

   

Maternal medical conditions & medical complications of pregnancy

      

 Yes

1164 (37.78)

1917 (62.22)

1.40 (1.33, 1.47)

< 0.001

1.25 (1.19, 1.32)

< 0.001

 No

5116 (27.04)

13802 (72.96)

Ref.

 

Ref.

 

Obstetric complications

  

.

   

 Yes

763 (71.78)

300 (28.22)

2.71 (2.59, 2.83)

< 0.001

2.16 (2.02, 2.31)

< 0.001

 No

5594 (26.45)

15554 (73.55)

Ref.

 

Ref.

 

Fetal complications

      

 Yes

9 (50.00)

9 (50.00)

1.75 (1.10, 2.77)

0.02

1.06 (0.67, 1.68)

0.79

 No

6348 (28.60)

15845 (71.40)

Ref.

 

Ref.

 

Maternal transfer-in

      

 Yes

896 (58.60)

633 (41.40)

2.22 (2.11, 2.33)

< 0.001

1.42 (1.32, 1.52)

< 0.001

 No

5435 (26.40)

15152 (73.60)

Ref.

 

Ref.

 
  1. Abbreviations: RR = risk ratio; CI = confidence interval
  2. Bold text indicates estimates with p-values < 0.05.
  3. 1 The unadjusted models were modeled for each variable separately for the outcome using Poisson regression with natural logarithm (log) as the link function and robust standard errors.
  4. 2 The adjusted model included the primary exposure (nighttime/weekend delivery) and any covariates with p-value < 0.20 in the unadjusted models, and used Poisson regression with natural log link and robust standard errors.
  5. 3 Though parity and gravidity each have p-values < 0.20 in the unadjusted models, we included only parity in the adjusted model based on presumed collinearity between the two variables
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