Maternal and neonatal morbidity during off peak hours in a busy obstetric unit. Are deliveries after midnight more complicated?. (19th December 2013)

• Record Type: Journal Article
• Authors: Hehir, Mark P.; Walsh, Jennifer M.; Higgins, Shane; Mahony, Rhona
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 2(2014)
• Page Start: 189
• Page End: 193
• Publication Date: 2013-12-19
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12307
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12307-abs-0001"> <title>Abstract</title> <sec id="aogs12307-sec-0001" sec-type="section"> <title>Objective</title> <p>We sought to compare maternal and neonatal outcomes in deliveries occurring overnight with those in daylight hours.</p> </sec> <sec id="aogs12307-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective observational study.</p> </sec> <sec id="aogs12307-sec-0003" sec-type="section"> <title>Setting</title> <p>Large national tertiary referral center.</p> </sec> <sec id="aogs12307-sec-0004" sec-type="section"> <title>Population</title> <p>All singleton laboring nulliparous parturients delivering infants >500 g over a 2‐year period, 1 January 2008 to 31 December 2009.</p> </sec> <sec id="aogs12307-sec-0005" sec-type="section"> <title>Methods</title> <p>Details of intrapartum characteristics and neonatal outcomes of deliveries occurring between midnight and 08.00 h were compared with deliveries occurring outside of these hours.</p> </sec> <sec id="aogs12307-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Maternal and neonatal morbidity.</p> </sec> <sec id="aogs12307-sec-0007" sec-type="section"> <title>Results</title> <p>During the study period there were 8450 nulliparous deliveries. 2668 (31.6%) delivered between midnight and 08.00 h, and 5782 (68.4%) outside of these hours. There was a significant difference between the time periods in the number of babies born with a cord pH <7.1: 10.8% (44/406) of babies were born between midnight and 08.00 h, and 6.3% (63/1007) of babies were born outside these hours (<italic>p</italic> = 0.003). There was no significant difference in terms of Apgar score <7 at 5 min (<italic>p</italic> = 0.17). There was a trend toward a larger number of anal sphincter injuries occurring between midnight and 08.00 h (3% vs. 2.3%; <italic>p</italic> = 0.05).</p> </sec> <sec id="aogs12307-sec-0008" sec-type="section"> <title>Conclusion</title> <p>Our findings suggest that infants are more likely to be born with a pH <7.1 and there was a trend toward an increased rate of anal sphincter injury during time periods when staffing levels are low and clinician fatigue may play a role in decision‐making and patient management. This may play a role in service provision planning and staff recruitment.</p> </sec> </abstract>