June 14, 2010 / 12:24 AM / 9 years ago

Birth complications found to be more common at night

NEW YORK (Reuters LIfe!) - Picking the time of day to give birth may not be a choice many women can make but it could influence her chances of a smooth delivery, according to a Dutch research.

A nurse measures the head of the newborn baby of Peruvian Gloria Cusi Quispe after she gave birth to him in the vertical position at the Belempampa Health Clinic in Cuzco May 23, 2008. REUTERS/Mariana Bazo

A study of more than 700,000 births at Dutch hospitals between 2000 and 2006 found that the risks of newborn death and admission to the neonatal intensive care unit were higher with nighttime than daytime deliveries.

The researchers said that the findings, published in obstetrics and gynecology journal BJOG (here) are in line with trends in other studies not only in obstetrics, but in hospital intensive care units as well.

Overall, the study found infants at smaller community hospitals who were born in the evening (between 6 p.m. and midnight) or overnight into early morning (between midnight and 8 a.m.) were 32 percent to 47 percent more likely to die than those born during the day.

Larger medical centers that would see more high-risk pregnancies — so-called tertiary centers - did not have as much of a difference between night and day. At these hospitals, only overnight births - as opposed to evening births — were linked to an increased risk of newborn death.

The findings were similar when the researchers looked at the risk of all adverse birth outcomes together.

But they stressed that in developed countries serious complications are rare no matter what time of day or night a woman delivers. “It is very important indeed to realize that risks are generally low and that the level of care in these kinds of Western countries is high,” researcher Dr. Eric Steegers of Erasmus University Medical Center in Rotterdam told Reuters Health.

Of the nearly 656,000 singleton births at community hospitals, between 0.05 and 0.09 percent of infants died during or soon after birth. Rates were higher among infants born at tertiary hospitals, but were still less than 1 percent.

Steegers said it is possible that the increased risks reflect the fact that fewer senior staff members — including obstetricians, neonatologists and anesthesiologists — are available during night shifts.

Supporting that idea, the researchers found fewer infant deaths and complications at community hospitals when experienced doctors may be making the initial decisions on how to manage high-risk situations.

Steegers said that more research is needed, however, to understand the extent to which hospital organization plays into the higher risk of childbirth complications at night.

It’s also possible that staff fatigue is a factor, since night-shift work is at odds with the body’s natural rhythms.

Reporting by Amy Norton, Editing by Belinda Goldsmith

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