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Association between time of day and performance, indications, and outcomes of obstetric interventions among nulliparous women delivering at term

Journal of Perinatology volume 39, pages 808–813 (2019)Cite this article

Subjects

Abstract

Objective

The objective of this study is to determine whether there is an association between delivery time and obstetric interventions, as well as maternal and perinatal outcomes.

Study design

Retrospective cohort study of nulliparous women delivering singleton, vertex, live births at ≥37 weeks gestation at a single center from 2014 to 2015. Nighttime deliveries were designated as those occurring between 18:00 and 05:59 h. The primary outcomes were obstetrical interventions (cesarean delivery, operative vaginal delivery, episiotomy). Secondary outcomes included indications for operative deliveries, as well as maternal and perinatal outcomes.

Results

Of 7691 women eligible for inclusion, 3707 (48.2%) delivered during the nighttime. Women who experienced nighttime deliveries had no demographic or clinical differences compared with women delivering during the daytime. Women delivering during the nighttime had greater odds of cesarean delivery (OR 1.27, 95% CI 1.14–1.43) and operative vaginal delivery (OR 1.83, 95% CI 1.20–2.78). Women who delivered at night were also more likely to have neonates with a 5 min Apgar score <7 (OR 1.59, 95% CI 1.08–2.32) and umbilical artery pH < 7.0 (OR 1.76, 95% CI 1.18–2.63). There were no differences observed in any of the other outcomes examined.

Conclusions

Delivery during the nighttime is associated with alterations in some obstetric interventions and perinatal outcomes

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Acknowledgements

Funding:

LMY and ESM were supported by the NICHD K12 HD050121-11 and K12 HD050121-09, respectively, at the time of the study. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Lilly Y. Liu

  2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Lilly Y. Liu, Emily S. Miller & Lynn M. Yee

Authors
  1. Lilly Y. Liu
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  2. Emily S. Miller
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  3. Lynn M. Yee
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Corresponding author

Correspondence to Lilly Y. Liu.

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The authors declare that they have no conflict of interest.

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Presentation: This abstract was presented as a poster presentation at the ACOG 65th Annual Clinical and Scientific Meeting, in San Diego, California, on 6–9 May 2017.

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Liu, L.Y., Miller, E.S. & Yee, L.M. Association between time of day and performance, indications, and outcomes of obstetric interventions among nulliparous women delivering at term. J Perinatol 39, 808–813 (2019). https://doi.org/10.1038/s41372-019-0353-6

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