title: 24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes.
abstract: ObjectiveThe objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff.DesignThis was a retrospective study conducted over 5 years between 2008 and 2012.SettingThis study was set at the obstetric delivery unit in a tertiary hospital.PopulationA total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections.Materials and MethodsData were collected using the hospital electronic medical records. Time periods of 8 hours were defined (daytime between 8 am and 4 pm, evening time between 4 pm and 12 pm, and nighttime between 12 pm and 8 am). Differences between the three time periods were assessed using software R Core Team (2013). Main outcome measures were neonatal birth asphyxia, neonatal intensive care unit admission, and neonatal death.ResultsThere were no differences in perinatal and maternal outcomes in the course of the day, apart from a higher incidence of third- and fourth-degree tears during the evening. Neonatal outcome after obstetric emergencies (uterine rupture, partial placental abruption, and cord prolapse) also showed no day-night differences.ConclusionAdverse nighttime-related outcomes may be avoided by the 24/7 presence of experienced medical staff.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal.
authors: Sara
authors: S
authors: Tavares
authors: Department of Obstetrics and Gynecology, Centro Hospitalar São João, Porto, Portugal.
authors: João
authors: J
authors: Cavaco-Gomes
authors: Department of Obstetrics and Gynecology, Centro Hospitalar São João, Porto, Portugal.
authors: Marina
authors: M
authors: Moucho
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal.
authors: Milton
authors: M
authors: Severo
authors: Department of Pediatrics, Centro Hospitalar São João, Porto, Portugal.
authors: Mário
authors: M
authors: Mateus
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal.
authors: Carla
authors: C
authors: Ramalho
authors: Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
authors: Gerard H A
authors: GHA
authors: Visser
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal.
authors: Nuno
authors: N
authors: Montenegro
mesh_terms: D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008505:Medical Staff, Hospital; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D018743:Perinatal Care; D010561:Personnel Staffing and Scheduling; D011174:Portugal; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016526:Workload