所谓的“周末效应”已在许多发达国家临床上以及跨学科内被广泛地研究过。目前的研究是产科内最广泛的调查。
一项在妇产科内新的研究显示“周末效应”已到达令人担忧的程度。
一项发表在BMJ杂志上的新研究，证明了预产期在周末的孕妇和婴儿会有较高的并发症发生率。
The study looked at more than 1 million patients admitted to English hospitals over a 2-year period.
这项研究在英国医院持续两年调查了超过一百万的孕妇。
Researchers found a significant increase in a number of negative health outcomes for expectant mothers admitted to hospitals on Saturdays and Sundays.
研究人员发现，一些预产孕妇在周六和周日去医院得到的不良健康结果显著增加。
The controversial weekend effect appears to show a negative association between the day of delivery and measures of quality and safety of maternal care.
这个有争议的周末效应似乎显示了孕妇去医院的日子和产妇保健的质量和得到的医疗服务呈现负关联。
什么是“周末效应”？
In short, the weekend effect hypothesizes that patients admitted to hospitals during the weekend face more risks than those arriving midweek.
简而言之，“周末效应”就是患者送往医院的日子中，周末比平时面对更多的风险。
Because of the huge amount of factors at play, studies into this effect have generated mixed results. Disparate areas of health care have been investigated, but results have thrown up as many questions as they have answered.
由于多因素发挥作用，研究这种效应产生出的是混杂的结果。目前已在不同的医疗保健部门进行了调查，但似乎结果越多，问题也越多。
Despite the range of results, some of the findings are worrying enough to merit further investigation.
尽管有一系列结果，但一些调查结果却令人担忧，值得进一步调查。
For instance, a study into acute myocardial infarctions in 922,074 elderly American patients found that those who were hospitalized at the weekend had an elevated 1-year mortality rate.
例如，在一项老年美国人急性心肌梗死的922074例患者中，发现那些在周末住院1年之内死亡率较高。
Another study investigated weekend admissions in Ontario, Canada. Researchers found that weekend patients presenting with ruptured abdominal aortic aneurysms, acute epiglottitis and pulmonary embolism saw significantly higher in-hospital mortality rates than weekday admissions.
另一项研究在加拿大安大略省进行。研究人员发现，周末患者腹主动脉瘤破裂，急性会厌炎和肺栓塞死亡率比平日多。
产科新研究
The weekend effect has been investigated within obstetrics previously, but studies to date have produced conflicting results. This latest study, the most comprehensive to date, set out to have a thorough look at this troublesome phenomenon.
在产科，之前“周末效应”已有研究。但目前为止，这些研究已经产生了相互矛盾的结果。在这项最新研究中，至今最易于理解的，也出现了很复杂的局面。
The research team, from Imperial College London, delved into the details of 1,332,835 deliveries and 1,349,599 births within the English National Health Service between April 2010 and March 2012.
来自帝国理工学院的研究团队，在2010年4至2012年3月之间，研究了英国1332835名送至医院的孕妇以及1349599个婴儿的出生。
Analysis focused on the day of delivery and associated outcomes across the days of the week. It also looked at measures of quality and safety of maternity services.
研究分析了孕妇送至医院的时间和临床结果的关系。也研究医疗服务质量和安全性。
Across the board, Thursdays saw the highest number of births and Sundays the fewest.
总的来看，周四有最高的出生人数而周日最少。
Outcomes of particular interest were perinatal mortality, (death within the first 7 days after birth), emergency re-admissions, infections, perineal tears and injuries during birth.
结果中着重研究了住院期间胎儿死亡率（在出生后7天内死亡的胎儿），紧急再入院，感染和会阴撕裂。
Results were carefully adjusted for a variety of influential factors, such as mother's age, socioeconomic factors, ethnicity, previous cesarians, diabetes, blood pressure, pre-eclampsia, eclampsia and more.
研究结果小心的排除了各种影响因素，如母亲的年龄，种族，社会经济因素，cesarians，糖尿病，高血压，先兆子痫，子痫等等。
在周末去妇产科更危险
研究团队发现他们正在调查出生指标中的四项在周末较平时要差：如围产儿死亡率，产妇感染，出生是意外损伤和出生3天内婴儿急诊入院。
A result that stood out particularly was the level of perinatal mortality.0
围产儿死亡率尤其突出。
During weekdays, perinatal mortality was at 6.5 per 1,000 cases; at the weekend, this increased to 7.1 per 1,000. Infections were also generated more regularly at weekends. Weekdays saw 8.2 infections per 1,000 births, while the weekend generated 8.7 per 1,000.
在工作日期间，围产儿死亡率为每1000例中有6.5例末，而在周末时，这增加到每1000例中有7.1例。周末也存在更多的感染风险。工作日中每1000个新生儿感染8.2例，而周末为每1000例中有8.7例。
These increases equate to a total of 770 additional perinatal deaths per year (out of the annual total of around 4,500) and 470 additional maternal infections yearly.
这些数字等同于每年有770例额外的围产儿死亡（正常为4500例）以及470例额外的产妇感染。
The number of emergency readmissions also increased over the weekend. Saturdays and Sundays saw 12.3 per 1,000, compared with 11.8 per 1,000 during the week.
急诊入院的人数在周末也增加了。周六和周日中每1000孕妇中有12.3例，而工作日中只有11.8例。
Prof. Paul Aylin, from the School of Public Health at Imperial College, London, the senior academic on the team, says:
团队的高级学术顾问，伦敦帝国大学公共卫生学院的Paul Aylin教授说：
“在我们的文章中，我们试图解释在不同的日子不同的并发症发生率可能是概率原因，或是婴儿在某些特定的日子里出生在某种程度上更复杂。
However, even after making these adjustments, we found the rates of complications vary on different days."
然而，即使排除了影响因素，我们仍然发现并发症的发生率在不同的日子也是不同的。”
是医院工作人员的责任吗？
该研究小组发现，医院工作人员和胎儿死亡或受伤并没有相关性。
The authors are quick to stress that their data is from 2012, so any changes over recent years will not have been taken into account. They also make it clear that the study was observational and cannot, therefore, be used to apportion cause and effect.
作者也强调，他们的数据来源于2012年，所以在最近几年的任何变化都未被考虑在内。他们也明确表示，这项研究是观察性的，不能用于解释这些因果关系。