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The MFMU Cesarean Registry: impact of time of day on cesarean complications.

Authors :: Bailit JL
Landon MB
Thom E
Rouse DJ
Spong CY
Varner MW
Moawad AH
Caritis SN
Harper M
Wapner RJ
Sorokin Y
Miodovnik M
O'Sullivan MJ
Sibai BM
Langer O
Source :: American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2006 Oct; Vol. 195 (4), pp. 1132-7. Date of Electronic Publication: 2006 Jul 26.
Publication Year :: 2006
Abstract: Objective: Studies suggest that sleep deprivation adversely affects performance. We hypothesized that cesarean delivery complications would be more frequent during the night shift (11 pm-7 am), and evaluated morbidities by delivery shift.<br />Study Design: Eighteen thousand nine hundred and thirty-nine term women undergoing an unscheduled cesarean delivery in 13 centers from 1999 to 2000 within a prospective observational study were included. Maternal/neonatal morbidities and time from decision to cesarean delivery were evaluated by time of delivery (7 am-3 pm, 3 pm-11 pm, 11 pm-7 am). A composite of maternal morbidities was evaluated by logistic regression controlling for potentially confounding factors.<br />Results: Controlling for age, race, insurance, cardiac disease, preeclampsia, diabetes, previous incision type, and prenatal care, shift of delivery had no impact on maternal morbidity (11 pm-7 am OR 0.9 [95% CI 0.81-1.0]). NICU admissions were slightly increased at night but neonatal complications were not.<br />Conclusion: Maternal and neonatal complications of cesarean delivery do not increase with delivery during the night shift.