24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes

Tavares, Sara; Cavaco-Gomes, João; Moucho, Marina; Severo, Mílton; Mateus, Maria do Nascimento Esteves; Ramalho, Carla; Visser, Gerard H.A.; Montenegro, Nuno

doi:10.1097/01.ogx.0000526816.16579.d4

Cited by 5 publications

(7 citation statements)

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“…However, poor perinatal outcome was not significantly associated with time of delivery. Our results are in line with previous studies [9] although refuted by others from resource limited-settings [10].…”

Section: Discussionsupporting

confidence: 94%

A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

Wade¹,

Faye²,

Ndiaye³

et al. 2020

OJPed

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Section: Discussionsupporting

confidence: 94%

A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

Wade¹,

Faye²,

Ndiaye³

et al. 2020

OJPed

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“…Previous literature has shown conflicting evidence in the outcomes of neonates born in the evening and nighttime hours, which may be related to the quality of resuscitation and NRP adherence during these time periods 16 , 17 , 18 , 20 , 21 , 22 , 23 . In this analysis, we used video recordings scored with the mNRA tool to determine if adherence to NRP differed between resuscitations of infants born during daytime, evening, or nighttime hours.…”

Section: Discussionmentioning

confidence: 99%

“…Shift length, off-hours shifts, and physician fatigue have long been implicated as contributors to medical errors and poor outcomes 20 . Several studies have identified no significant temporal variations in rates of intrapartum and neonatal morbidity and mortality 21 , 22 , 23 . However, others have shown that despite higher risk births occurring during daytime hours, infants born at night and during high-volume days and weekends have an increased risk of adverse neonatal complications.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, recent literature suggests potentially worsened outcomes of neonates resuscitated at birth during evening and nighttime hours 16 , 17 , 18 , 19 . Shift length, shifts scheduled outside of typical daytime hours, and physician fatigue can result in increased patient load and capacity strain on perinatal providers during nighttime hours and potentially contribute to medical errors and poor outcomes 20 , 21 , 22 , 23 . The objective of our study was therefore to compare adherence to NRP in resuscitations that occurred during daytime hours, evening hours, and nighttime hours using video recordings and mNRA scores as a surrogate marker of adherence.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of temporal variations in adherence to NRP using video recording in the delivery room

2021

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Introduction Video recording and video evaluation tools have been successfully used to evaluate neonatal resuscitation performance. The objective of our study was to evaluate differences in Neonatal Resuscitation Program (NRP) adherence at time of birth between three temporal resuscitative periods using scored video recordings. Methods This is a retrospective review of in-situ resuscitation video recordings from a level 3 perinatal center between 2017 and 2018. The modified Neonatal Resuscitation Assessment (mNRA) scoring tool was used as a surrogate marker to assess NRP adherence during daytime, evening, and nighttime hours. Results A total of 260 resuscitations, of which 258 were births via Cesarean section, were assessed. mNRA composite scores were 86.2% during daytime hours, 87% during evening hours, and 86.6% during nighttime hours. There were no significant differences in mNRA composite scores between any of the three time periods. Differences remained statistically similar after controlling for complexity of resuscitations with administration of positive pressure ventilation (PPV), intubation, or chest compressions. Conclusion Overall adherence to NRP, as measured by composite mNRA scores as a surrogate marker, was high across all three daily resuscitative periods without significant differences between daytime, evening, and nighttime hours.

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“…International wurden in den letzten 5 Jahren divergierende Studienergebnisse zum "Wochenendeffekt in der Geburtshilfe" veröffentlicht: Während nach den Ergebnissen von Hoque und Hoque ihrem Geburtenkollektiv in der Nacht mehr Kinder mit pH-Werten < 7,10 (10,8 gegenüber 6,3 %) geboren wurden [16][17][18]. Und Gijsen et al (2012) berichteten über Ergebnisse einer Registerstudie, die auf der Analyse von 450 000 Geburten in den Niederlanden beruhte.…”

Section: Diskussionunclassified

Gibt es einen negativen Nacht- oder Wochenendeffekt auf den kindlichen postnatalen Zustand bei Frauen mit Migrationshintergrund?

David

Henrich

Schlembach

et al. 2019

Z Geburtshilfe Neonatol

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Zusammenfassung Fragestellung Ist bei Frauen mit Migrationshintergrund (MH) (=Proxy-Variable für erhöhtes Risiko kultureller/sprachlicher Kommunikationsprobleme) die neonatale Morbidität außerhalb der Regelarbeitszeit erhöht? Methoden Datenerhebung an 3 Berliner Geburtskliniken mit Fragebogenset (soziodemografische, Versorgungsaspekten, Migration); Ergänzung durch Mutterpassangaben und Klinik-Perinataldaten. Surrogatmarker für kindliche Morbidität: Apgar-, Nabelschnur-pH-Wert, Verlegung in eine Kinderklinik. Deskriptive und logistische Regressions-Analysen wurden durchgeführt. Ergebnisse Datensätze von 2014 Migrantinnen der 1., 771 Frauen der 2. Generation, 2564 Frauen ohne MH wurden einbezogen, darunter 39,7% sog. Tagesgeburten (Montag – Freitag, jeweils 7:00–18:00 Uhr). In 2 Modellen wurde für die beiden Proxy-Parameter der kindlichen Morbidität der Einfluss der Geburtszeit und verschiedener anderer Parameter überprüft. Die Chancen für ungünstige Apgar- oder Nabelschnur-pH-Werte waren z. B. bei einer Geburt in den Abend- und Nachtstunden, am Wochenende und an Feiertagen (OR 1,84; 95% CI 1,23–2,76; p=0,003), bei vaginal-operativen Geburten (OR 3,36; 95% CI 2,07–5,46, p<0,001) oder einer sekundären Sectio (OR 1,94; 95 CI 1,28–2,96, p=0,002) erhöht, nicht aber bei einem MH der Gebärenden. Zusammenfassung Gebärende mit MH werden trotz möglicher interkultureller und sprachlicher Kommunikationsprobleme unabhängig von Tageszeit und Wochentag ebenso gut versorgt wie Schwangere ohne MH.

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24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes

Cited by 5 publications

References 0 publications

A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

Assessment of temporal variations in adherence to NRP using video recording in the delivery room

Gibt es einen negativen Nacht- oder Wochenendeffekt auf den kindlichen postnatalen Zustand bei Frauen mit Migrationshintergrund?

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