24/7 Presence ofMedical Staff in the LaborWard; No Day–Night Differences in Perinatal and Maternal Outcomes

Abstract

Objective: The 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. Design: This was a retrospective study conducted over 5 years between 2008 and 2012. Setting: This study was set at the obstetric delivery unit in a tertiary hospital. Population: A 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 Methods: Data 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. Results: There were no differences in perinatal andmaternal 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. Conclusion: Adverse nighttime-related outcomes may be avoided by the 24/7 presence of experienced medical staff.