Time of delivery and neonatal morbidity and mortality

Caughey, Aaron B.; Urato, Adam C.; Thiet, Mari-Paule; Lee, Kathryn A.; Washington, A. Eugene; Laros, Russell K.

doi:10.1016/j.ajog.2005.10.713

Cited by 13 publications

(22 citation statements)

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“…Another limitation was the lack of information on actual staffing levels just before and during each delivery individually. Maternity ward staffing is typically a healthcare organisation issue that, despite its potential importance in clinical and economic outcomes, is not often studied 34 . Our seniority index essentially reflects availability, rather than actual use, of senior competence, although the former will always be a precondition for the latter.…”

Section: Discussionmentioning

confidence: 99%

Increased adverse perinatal outcome of hospital delivery at night

Graaf

Ravelli

Visser

et al. 2010

BJOG

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Objective To determine whether delivery in the evening or at night and some organisational features of maternity units are related to perinatal adverse outcome.Design A 7-year national registry-based cohort study.Setting All 99 Dutch hospitals.Population From nontertiary hospitals (n = 88), 655 961 singleton deliveries from 32 gestational weeks onwards, and, from tertiary centres (n = 10), 108 445 singleton deliveries from 22 gestational weeks onwards.Methods Multiple logistic regression analysis of national perinatal registration data over the period 2000-2006. In addition, multilevel analysis was applied to investigate whether the effects of time of delivery and other variables systematically vary across different hospitals.Main outcome measures Delivery-related perinatal mortality (intrapartum or early neonatal mortality) and combined delivery-related perinatal adverse outcome (any of the following: intrapartum or early neonatal mortality, 5-minute Apgar score below 7, or admission to neonatal intensive care).Results After case mix adjustment, relative to daytime, increased perinatal mortality was found in nontertiary hospitals during the evening (OR, 1.32; 95% CI, 1.15-1.52) and at night (OR, 1.47; 95% CI, 1.28-1.69) and, in tertiary centres, at night only (OR, 1.20; 95% CI, 1.06-1.37). Similar significant effects were observed using the combined perinatal adverse outcome measure. Multilevel analysis was unsuccessful; extending the initial analysis with nominal hospital effects and hospital-delivery time interaction effects confirmed the significant effect of night in nontertiary hospitals, whereas other organisational effects (nontertiary, tertiary) were taken up by the hospital terms.Conclusion Hospital deliveries at night are associated with increased perinatal mortality and adverse perinatal outcome. The time of delivery and other organisational features representing experience (seniority of staff, volume) explain hospital-to-hospital variation.Keywords Adverse perinatal outcome, early neonatal mortality, intrapartum mortality, organisation of maternity units, seniority of staff, timing of hospital delivery, volume of deliveries.

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Section: Discussionmentioning

confidence: 99%

Increased adverse perinatal outcome of hospital delivery at night

Graaf

Ravelli

Visser

et al. 2010

BJOG

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“…New physicians begin working in the summer, and the clinical experience of these young physicians is lowest in July and August. Previous studies have suggested that the timing of birth has significant effects on the risks of perinatal and neonatal mortality, but these findings have not been consistent when comparing day versus night,1–14 weekday versus weekend,1,2,5,15–20 and July and August versus the rest of the year 5,21,22…”

Section: Introductionmentioning

confidence: 89%

“…Even less is known about the impact of timing of birth on morbidity among surviving VLBW infants 12,14,22. If significant effects of timing of birth on mortality and morbidity were demonstrated, this would suggest potentially modifiable factors, such as staffing policies and delivery room management, that could be addressed with the goal of improving outcomes.…”

Section: Introductionmentioning

confidence: 99%

Impact of Timing of Birth and Resident Duty-Hour Restrictions on Outcomes for Small Preterm Infants

et al. 2010

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“…Some studies reported increased risks for births during the evening or night, leading to questions about the quality of care provided during night-time [16][17][18][19][20]. But, two retrospective cohort studies including great numbers of deliveries did not find any significant differences in neonatal morbidity or mortality by time of delivery [21][22]. In our study, the risk of NICU admission for infants increased if the birth took place at night.…”

Section: Discussionmentioning

confidence: 50%

When Should the Labor Induction be Started For Late-term Pregnancies, in the Morning or in the Evening?

Kokanali¹,

Cavkaytar²,

Topçu³

et al. 2016

Ann Clin Anal Med

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ÖzetGiriş: Intravenöz oksitosin infüzyonu ile doğum indüksiyonu sabah ya da akşam başlatılan geç-term gebeliklerin sonuçlarını incelemek. Gereç ve Yöntem: Sefalik prezantasyonda tekil gebeliğe sahip, gebelik yaşı 41 0/7 haftadan 41 6/7 haftaya kadar olan 266 tane gebe bu retrospektif çalışmaya katılmıştır. İntravenöz oksiosin ile doğum indüksiyonları sabah saatlerinde (08.00-12.00) ya da akşam saatlerinde (16.00-20.00) başlatılmıştır. Doğum sonuçları ve gece saatlerindeki (20.00-08.00) doğumlar kaydedilmiştir. Bulgular: Primipar gebelerde, doğum eylemi süresi, doğum eyleminin aktif faz uzunluğu akşam grubunda sabah grubuna göre anlamlı olarak daha kısaydı. Multipar gebelerde, gece saatlerinde doğum oranı akşam grubunda sabah grubuna göre anlamlı derecede daha fazla idi. Ayrıca gece saatlerinde doğum, yenidoğan yoğun bakım ünitesine başvurmak için anlamlı bir risk faktörü olarak bulundu. Tartışma: İntravenöz oksitosin infüzyonu ile akşam başlatılan doğum indük-siyonu, primipar gebelerde doğum eylemi süresini kısaltırken multipar gebelerde kısaltmaz. Gece saatlerindeki doğum kötü perinatal sonuç için risk faktörü olabilir. Doğum indüksiyonu planlanırken, parite, indüksiyon başlama zamanı ve tahmini doğum saati olası kötü neonatal sonuçları azaltmak için dikkate alınmalıdır.Anahtar Kelimeler Doğum İndüksiyonu; Oksitosin; Sabah; Akşam Abstract Aim: We aimed to investigate the labor outcomes of late-term pregnancies underwent intravenous oxytocin induction starting in the morning compared with starting in the evening. Material and Method: 266 women with a singleton pregnancy in cephalic presentation, at gestational age of 41 0/7 through 41 6/7 weeks were enrolled in this retrospective study. Labor inductions with intravenous oxytocin were started in the morning hours (08.00-12.00) or in the evening hours (16.00-20.00). Labor outcomes and night-time (20.00-08.00) deliveries were recorded. Results: In primiparae group, labor duration and active phase length of labor were significantly shorter in the evening group than in the morning group. In multiparae women, the ratio of nighttime delivery was significantly higher in evening group as compared to morning group. And also night-time delivery was found as a significant risk factor for neonatal intensive care unit admission. Discussion: Induction of labour with intravenous oxytocin starting in the evening shortens labor duration in primiparae women, but not in multiparae women. Night-time delivery may be a risk for poor perinatal outcome. As the labor induction is planned, parity, start time of induction and estimated delivery time should be taken into account to reduce the risk of poor neonatal outcome in late-term pregnancies.

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Time of delivery and neonatal morbidity and mortality

Cited by 13 publications

References 0 publications

Increased adverse perinatal outcome of hospital delivery at night

Increased adverse perinatal outcome of hospital delivery at night

Impact of Timing of Birth and Resident Duty-Hour Restrictions on Outcomes for Small Preterm Infants

When Should the Labor Induction be Started For Late-term Pregnancies, in the Morning or in the Evening?

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