title: The MFMU Cesarean Registry: impact of time of day on cesarean complications.
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.
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bailit
authors.forename: Mark B
authors.initials: MB
authors.lastname: Landon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Thom
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Atef H
authors.initials: AH
authors.lastname: Moawad
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.forename: Oded
authors.initials: O
authors.lastname: Langer
mesh_terms: 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