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


METHODS
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.


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.


CONCLUSIONS
Maternal and neonatal complications of cesarean delivery do not increase with delivery during the night shift.
Bailit
Jennifer L
JL
Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
Landon
Mark B
MB
Thom
Elizabeth
E
Rouse
Dwight J
DJ
Spong
Catherine Y
CY
Varner
Michael W
MW
Moawad
Atef H
AH
Caritis
Steve N
SN
Harper
Margaret
M
Wapner
Ronald J
RJ
Sorokin
Yoram
Y
Miodovnik
Menachem
M
O'Sullivan
Mary J
MJ
Sibai
Baha M
BM
Langer
Oded
O
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009017:Morbidity; D011247:Pregnancy; D012042:Registries; D013997:Time Factors; D014940:Work Schedule Tolerance