title: Seasonally adjusted birth frequencies follow the Poisson distribution.
abstract: BACKGROUND
  Variations in birth frequencies have an impact on activity planning in maternity wards. Previous studies of this phenomenon have commonly included elective births. A Danish study of spontaneous births found that birth frequencies were well modelled by a Poisson process. Somewhat unexpectedly, there were also weekly variations in the frequency of spontaneous births. Another study claimed that birth frequencies follow the Benford distribution. Our objective was to test these results.
  
  
  METHODS
  We analysed 50,017 spontaneous births at Akershus University Hospital in the period 1999-2014. To investigate the Poisson distribution of these births, we plotted their variance over a sliding average. We specified various Poisson regression models, with the number of births on a given day as the outcome variable. The explanatory variables included various combinations of years, months, days of the week and the digit sum of the date.
  
  
  RESULTS
  The relationship between the variance and the average fits well with an underlying Poisson process. A Benford distribution was disproved by a goodness-of-fit test (p < 0.01). The fundamental model with year and month as explanatory variables is significantly improved (p < 0.001) by adding day of the week as an explanatory variable. Altogether 7.5% more children are born on Tuesdays than on Sundays. The digit sum of the date is non-significant as an explanatory variable (p = 0.23), nor does it increase the explained variance. INERPRETATION: Spontaneous births are well modelled by a time-dependent Poisson process when monthly and day-of-the-week variation is included. The frequency is highest in summer towards June and July, Friday and Tuesday stand out as particularly busy days, and the activity level is at its lowest during weekends.
authors.affiliation: Helsetjenesteforskning Akershus universitetssykehus.
authors.forename: Mathias
authors.initials: M
authors.lastname: Barra
authors.affiliation: Helsetjenesteforskning Akershus universitetssykehus.
authors.forename: Jonas C
authors.initials: JC
authors.lastname: Lindstrøm
authors.affiliation: Allmennlegevakten Legevakten i Oslo.
authors.forename: Samantha S
authors.initials: SS
authors.lastname: Adams
authors.affiliation: Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Helsetjenesteforskning Akershus universitetssykehus.
authors.forename: Liv A
authors.initials: LA
authors.lastname: Augestad
mesh_terms: D001723:Birth Rate; D005260:Female; D006801:Humans; D009664:Norway; D016012:Poisson Distribution; D011247:Pregnancy; D012621:Seasons