title: [Delivery during time of shift change is not a risk factor for obstetric complication: a historical cohort study].
abstract: BACKGROUND
  The time of shift change is a unique time because the continuity of routine care is interrupted. The association between delivery during time of shift change and obstetric complications has not been evaluated.
  
  
  OBJECTIVE
  We hypothesized that delivery during time of shift change is at risk for obstetric complications.
  
  
  METHODS
  A historical cohort study was performed of all women with a singleton pregnancy undergoing a trial of labor at term during 2006-2010. Data was extracted from a computerized database that is continuously updated during Labor. The hour of delivery was divided into two categories: "morning shift" (09:30-15:00) and "time of shift change" which was defined 30 minutes prior to and 90 minutes past the official time of shift change, which occurs twice daily at 07:30 and 15:30. Multivariate logistic regression models were implemented to estimate the association between deliveries during "time of shift change" compared to "morning weekdays", with instrumental delivery (primary outcome) and prolonged second stage, unplanned cesarean section, postpartum hemorrhage, 5 minutes Apgar score < 7, admission to neonatal intensive care unit (NICU) and prolonged maternal hospitalization (secondary outcome).
  
  
  RESULTS
  A total of 16,341 deliveries were included in the cohort. No statistical difference in instrumental vaginal delivery was documented for women delivering during "time of shift change compared to morning shift weekdays (OR = 0.96, 95% CI: 0.83- 1.11, p = 0.605). None of the secondary outcomes were found at risk for women delivering during "time of shift change".
  
  
  CONCLUSIONS
  Delivery during "time of shift change" does not pose additional risk for obstetric complications.
authors.forename: Orna
authors.initials: O
authors.lastname: Reichman
authors.forename: Arnon
authors.initials: A
authors.lastname: Samueloff
authors.forename: Efraim
authors.initials: E
authors.lastname: Gdansky
authors.forename: Yael
authors.initials: Y
authors.lastname: Yekel
authors.forename: Ronit
authors.initials: R
authors.lastname: Calderon-Margalit
mesh_terms: D000328:Adult; D001034:Apgar Score; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay; D016015:Logistic Models; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010561:Personnel Staffing and Scheduling; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult