Time at birth and short-term outcomes among extremely preterm infants in Spain: a multicenter cohort study

Solís-García, Gonzalo; Ávila-Álvarez, Alejandro; Rodrigo, Fermín García‐Muñoz; Vento, Máximo; Tamayo, Tomás Sánchez; Zozaya, Carlos

doi:10.1007/s00431-022-04404-z

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…About the time of birth, studies in the review emphasised that women who delivered during the daytime at a health facility, as opposed to nighttime (between the hours of 8 p.m. and 8 a. m.), had a reduced risk of infant mortality [31,48]. In contrast, a study conducted in Spain found no distinction in terms of survival between births that occurred during the day and those that took place at night [110]. The only plausible reason attributed to the negative relationship between nighttime delivery and IMR was that the lack of proper/facility care at the time of birth increases the risk of neonatal deaths [48].…”

Section: Plos Onementioning

confidence: 99%

“…An increase in the rate of mortality was predominantly observed in areas that lacked access to 24-hour health facilities [48]. Studies in high-income countries have demonstrated that having facilities with medical personnel available 24/7 is a key factor in reducing infant mortality [110,111]. The importance of providing round-the-clock services could be linked to birth timing, such that women who go into labour at night are given the same attention as those for daytime delivery.…”

Section: Plos Onementioning

confidence: 99%

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Factors associated with infant mortality in Nigeria: A scoping review

Nwanze,

Siuliman,

Ibrahim

2023

PLoS ONE

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Background Infant mortality persists as a global public health concern, particularly in lower-middle-income countries (LIMCs) such as Nigeria. The risk of an infant dying before one year of age is estimated to be six times higher in Africa than in Europe. Nigeria recorded an infant mortality rate of 72.2 deaths per 1,000 live births in 2020, in contrast to the global estimate of 27.4 per 1,000 live births. Several studies have been undertaken to determine the factors influencing infant mortality. Objective This scoping review sought to identify and summarise the breadth of evidence available on factors associated with infant mortality in Nigeria. Methods This review followed the five-stage principles of Arksey and O’Malley’s framework. Four electronic databases were searched with no limit to publication date or study type: Ovid MEDLINE, PubMed, CINAHL Complete, and Web of Science. Selected studies were imported into Endnote software and then exported to Rayyan software where duplicates were removed. Included articles were thematically analysed and synthesised using the socioecological model. Results A total of 8,139 references were compiled and screened. Forty-eight articles were included in the final review. At the individual level, maternal- and child-related factors were revealed to influence infant mortality; socioeconomic and sociocultural factors at the interpersonal level; provision and utilisation of health services, health workforce, hospital resources and access to health services at the organisational level; housing/neighbourhood and environmental factors at the community level; and lastly, governmental factors were found to affect infant mortality at the public policy level. Conclusion Factors related to the individual, interpersonal, organisational, community and public policy levels were associated with infant mortality in Nigeria.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Factors associated with infant mortality in Nigeria: A scoping review

Nwanze,

Siuliman,

Ibrahim

2023

PLoS ONE

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“…In many areas, the deliveries of the smallest infants have been regionalized, and neonatologists are increasingly available throughout the 24-h day [2,[4][5][6]. Sufficient allocation of experienced personnel may be one of the key factors in reducing adverse outcomes [7][8][9]. Improvements in the fields of perinatology and neonatology justify the need for up-to-date knowledge about the time of birth and associated morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Most studies included all newborns in the study population, regardless of gestational age. Knowledge of associations between time of birth and neonatal mortality and morbidity among premature infants is limited [8, 11, 13, 14].…”

Section: Introductionmentioning

confidence: 99%

Time of Delivery Contributes to Mortality and Morbidity in Preterm Infants

Teivaanmäki,

Hallamaa,

Rantakari

et al. 2023

Neonatology

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Introduction: Knowledge about the time of birth and its impact on premature infants is essential when planning perinatal and neonatal care and resource allocation. We studied the time of birth and its contribution to early death and morbidity in preterm infants. Methods: We explored the time and mode of birth of infants with birthweight of <1,500 g and gestational age of <32+0/7 weeks. Additionally, we divided the infants into three groups stratified by their time of birth, i.e., during office hours, evening, and nighttime and assessed associations between these groups and mortality and morbidity. Results: The study comprised 1,610 infants of whom 156 (10%) died during their stay in neonatal intensive care unit. The highest number of deliveries occurred on Fridays (21%, n = 341/1,610), primarily due to high number of cesarean sections. Deliveries peaked on workdays at 10 a.m. and 2:00 p.m. Mortality was lowest among infants born on Fridays (6%, n = 21/341) and highest on Mondays (13%, n = 28/218). Intraventricular hemorrhage (IVH) (odds ratio [OR]: 1.50, 95% CI: 1.10–2.03, p = 0.010) and necrotizing enterocolitis (NEC) (OR: 2.11, 95% CI: 1.13–3.91, p = 0.019) were more common among infants born at nighttime. These associations attenuated after adjustment for covariates. Conclusion: Deliveries of premature infants peaked on Fridays. Mortality was lower among those born on Fridays, compared with Mondays. Many low-risk deliveries on Fridays may decrease, and the tendency to postpone high-risk deliveries to Mondays, increase the proportional risk of mortality. Indication of higher risk of IVH and NEC among infants born during nighttime may be due to different patient population.

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Evaluation of the relationship between day or night birth time and morbidities and mortality in premature infants less than 32 weeks in a Turkish NICU

Akin,

Cakir

2024

Journal of Tropical Pediatrics

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Staffing levels, fatigue, and intervention timing may vary based on working hours and potentially influence the clinical outcomes of newborns. It remains unclear how the birth time of premature infants throughout the day affects their clinical outcome. This study aimed to compare the clinical outcomes of premature infants born during and after work hours. In this single-center retrospective cohort study, infants born at <32 weeks of age were categorized into two groups based on birth time. The first group included infants born during daytime working hours on weekdays, whereas the second group included infants born during nighttime working hours on weekdays, weekends, and public holidays. Both groups were compared in terms of clinical outcomes. Data from 572 patients born at <32 weeks of age were analyzed, with 137 (24%) infants in the on-hours group and 435 (76%) in the off-hours group. No significant differences were observed between the groups in terms of gestational age (GA) (27.4 ± 2.8 weeks vs. 27.7 ± 2.7 weeks), birth weight (BW) (1132 ± 459 g vs. 1064 ± 450 g), and gender distribution (53.2% vs. 55.4% male) (P > .05). There were no significant differences in other clinical outcomes, morbidities, or mortality rates between the groups (P > .05). Despite potential fluctuations in neonatal intensive care unit (NICU) staffing levels during on- and off-duty hours, the morbidity and mortality of premature infants aged <32 weeks were not affected in our unit. Each NICU should assess whether delivery time influences clinical outcomes, based on unique care conditions. The change in clinical outcomes depending on the time of birth may be particularly important in low- and middle-income countries (LMIC). Negative results may be an indication that the staff is under excessive workload. In addition, by providing a solution to the cause of the detected problem, both clinical outcomes may be improved and patient care costs due to morbidity may be reduced. Our results may be particularly important for studies to be conducted on this subject in LMIC.

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Time at birth and short-term outcomes among extremely preterm infants in Spain: a multicenter cohort study

Cited by 4 publications

References 35 publications

Factors associated with infant mortality in Nigeria: A scoping review

Factors associated with infant mortality in Nigeria: A scoping review

Time of Delivery Contributes to Mortality and Morbidity in Preterm Infants

Evaluation of the relationship between day or night birth time and morbidities and mortality in premature infants less than 32 weeks in a Turkish NICU

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