Time of Birth and the Risk of Severe Unexpected Complications in Term Singleton Neonates
| Autor: | Elliott K. Main, Anisha Abreo, Shen-Chih Chang, Jeffrey B. Gould |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors Evening Adolescent Birth certificate Logistic regression California Young Adult 03 medical and health sciences 0302 clinical medicine After-Hours Care Pregnancy Risk Factors Infant Mortality Hospital discharge Humans Medicine 030212 general & internal medicine 030219 obstetrics & reproductive medicine business.industry Singleton Obstetrics Infant Newborn Parturition Pregnancy Outcome Infant Shift Work Schedule Obstetrics and Gynecology Odds ratio Risk adjustment Delivery Obstetric Hospitals Obstetric Labor Complications Cross-Sectional Studies Logistic Models Mixed effects Female business |
| Zdroj: | Obstetrics & Gynecology. 136:377-385 |
| ISSN: | 0029-7844 |
| Popis: | Objective To assess whether there is a relationship between evening, night, and weekend births and severe unexpected neonatal morbidity in low-risk term singleton births. Methods We conducted a population-based, cross-sectional analysis. Severe unexpected neonatal morbidity as defined by the National Quality Forum specification 0716 was derived from linked birth certificate and hospital discharge summaries for 1,048,957 low-risk singleton term Californian births during 2011 through 2013. The association between the nursing shift (7 am-3 pm vs 3-11 pm and 11 pm -7 am) and weekday compared with weekend birth and the risk of severe unexpected neonatal morbidity was estimated using mixed effects logistic regression models. Results Severe unexpected neonatal morbidity was higher among births during the 3-11 pm evening shift (2.1%) and the 11 pm-7 am night shift (2.1%), compared with those during the 7 am-3 pm day shift (1.8%). The adjusted odds ratios (ORs) were 1.10 (95% CI 1.06-1.13) for the evening shift and 1.15 (1.11-1.19) for the night shift. The adjusted ORs of severe unexpected neonatal morbidity were increased only on Sunday, as compared with other days (adjusted OR 1.08, 95% CI 1.02-1.14). When our analysis was by perinatal region, the increase was seen in four of the nine perinatal regions. Conclusion After risk adjustment, the risk of severe unexpected morbidity in the low-risk singleton California birth cohort was significantly increased on Sundays and births during evening and night shifts. These elevations were detected in only four of California's nine perinatal regions. Further analysis at the individual hospital level is warranted. |
| Databáze: | OpenAIRE |
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