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Term patients are more likely to be managed by junior residents. The purpose of this study is to determine whether there is a “July” phenomena during the academic year in outcomes of term patients.
We compared 1st and 4th quarter delivery records of 3696 term patients at a single tertiary academic center over 3 academic years. Congenital anomalies and stillborns were excluded. Statistical comparisons were made using chi-square and independent t-tests as appropriate (P<0.05) with regards to mean Apgar scores, cesarean delivery, and a composite of NICU admission or low Apgar scores (1-minute <4 or 5-minute <7).
There were 1954 deliveries in the first academic quarter and 1742 deliveries in the fourth quarter between July 2008 and June 2011. There were no statistically significant differences between quarters in maternal characteristics or birth weight. The overall cesarean delivery rate was 26.5% in the first quarter and 23.1% in the fourth quarter. The primary cesarean rate was 15.4% versus 13.6% in the first and fourth quarter, respectively. There was no statistically significant difference between quarters in these respective rates. There was no difference between 1- and 5-minute mean Apgar scores in the first and fourth quarter. The composite rate of NICU admission or low Apgar scores was 4.1% in the first quarter and 3.6% in the fourth quarter. This difference was not statistically significant.
Our data suggest that there is not a July phenomenon in term obstetric patients at our institution. The quarter of the academic year does not influence route of delivery or neonatal outcome. Previous data shows no ‘July’ obstetric phenomena among all deliveries without regard to gestational age. We showed this phenomenon seems to hold true for term patients who are more likely to be managed by junior residents.