The hour of birth: comparisons of circadian pattern between women cared for by midwives and obstetricians

Heres, Marion; Pel, Maria; Borkent-Polet, Marion; Treffers, P.E.; Mirmiran, M.

doi:10.1054/midw.1999.0210

Cited by 15 publications

(21 citation statements)

References 17 publications

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“…Such a hypothesis is plausible, although the analgesic response may be influenced by complex interactions among several other factors. These include an affective dimension and appraised meaning of pain and beliefs about the etiology of pain, in addition to the circadian pattern of labor as previously demonstrated (Yerushalmy, 1938;Malek, 1952;Smolensky et al, 1972;Panduro-Baron et al, 1994;Heres et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, bias here was unlikely; some unmeasured, confounding residual effects could have persisted, but it is unlikely that these would have changed the direction of the conclusions. Third, it is important to note that many factors may influence the 24-h variation of pain relief in labor, i.e., type of pain (visceral, somatic), type of medications, time-of-day when the medications are administered, and circadian variation of the duration of labor (Aya et al, 2004;Chassard et al, 2007;Heres et al, 2000). Thus, considering all these aspects, and the fact that the more frequent the observations, the more accurate the characteristics of the 24-h variations are likely to be, we divided the day in six equal periods.…”

Section: Discussionmentioning

confidence: 99%

“…In the same study, among women under midwives' care, the peak time of delivery was 08:42 h in primiparous and 05:00 h in multiparous W. Schneider Vieira et al 866 women (Heres et al, 2000). Furthermore, some studies showed a circadian pattern in the onset of spontaneous labor, with a peak ∼00:00 h (King, 1956;Charles, 1953;Backe, 1991;Smolensky et al, 1972).…”

Section: Introductionmentioning

confidence: 90%

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Biological Rhythms of Spinal-Epidural Labor Analgesia

Vieira

Hidalgo²,

Torres³

et al. 2010

Chronobiology International

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Pain exhibits temporal variations in intensity due to multiple factors, including endogenous neuroendocrine and various external influences that vary over the 24 h. Also, medications can vary in potency and/or toxicity according to the time when they are administered. However, there is no consensus among studies regarding the 24-h pattern of analgesia during labor. Taking into account the time-of-day when labor analgesia is administered, this study aimed to answer two questions: (i) Is there diurnal variation in visual analogue scale (VAS)-rated pain relief and duration of intrathecal analgesia in patients undergoing labor analgesia? (ii) If there is, what is the influence of the duration of labor on the diurnal variation of the level of pain relief and duration of intrathecal analgesia? This prospective cohort included 41 healthy, nulliparous women in the first stage of labor undergoing spinal-epidural (CSE) analgesia using fentanyl combined with bupivacaine. Subjects had an epidural catheter fitted for additional, patient-controlled analgesia (PCA) if their pain relief was unsatisfactory. The number of VAS assessments (n = 558) was divided into six time periods of the 24 h. The adjusted coefficient of determination (r(2)), the proportion of the variance explained by the association between the duration of labor and the temporal pattern of the outcomes variable, was 58% (r(2) = 0.58) for pain relief and 44% (r(2) = 0.44) for duration of intrathecal analgesia. The peak effect of labor analgesia occurred between 02:00 and 05:59 h. However, the duration of intrathecal analgesia showed two peaks, i.e., at approximately 00:00 and approximately 12:00 h. These results demonstrate that labor analgesia achieved by fentanyl combined with bupivacaine shows a diurnal pattern in pain relief and duration of spinal analgesia. However, part of these temporal patterns was explained by the association with duration of labor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

Biological Rhythms of Spinal-Epidural Labor Analgesia

Vieira

Hidalgo²,

Torres³

et al. 2010

Chronobiology International

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“…High‐care facilities and multiple expert competences cannot be represented at all hospitals on a 24‐hour/7‐day basis, however, because of issues of cost‐effectiveness. In the Netherlands, 9% of deliveries are scheduled, but the majority of nonscheduled deliveries occur around the clock, with a biphasic pattern, including a peak – under natural conditions – in the early morning 2 …”

Section: Introductionmentioning

confidence: 99%

Increased adverse perinatal outcome of hospital delivery at night

Graaf

Ravelli

Visser

et al. 2010

BJOG

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Objective To determine whether delivery in the evening or at night and some organisational features of maternity units are related to perinatal adverse outcome.Design A 7-year national registry-based cohort study.Setting All 99 Dutch hospitals.Population From nontertiary hospitals (n = 88), 655 961 singleton deliveries from 32 gestational weeks onwards, and, from tertiary centres (n = 10), 108 445 singleton deliveries from 22 gestational weeks onwards.Methods Multiple logistic regression analysis of national perinatal registration data over the period 2000-2006. In addition, multilevel analysis was applied to investigate whether the effects of time of delivery and other variables systematically vary across different hospitals.Main outcome measures Delivery-related perinatal mortality (intrapartum or early neonatal mortality) and combined delivery-related perinatal adverse outcome (any of the following: intrapartum or early neonatal mortality, 5-minute Apgar score below 7, or admission to neonatal intensive care).Results After case mix adjustment, relative to daytime, increased perinatal mortality was found in nontertiary hospitals during the evening (OR, 1.32; 95% CI, 1.15-1.52) and at night (OR, 1.47; 95% CI, 1.28-1.69) and, in tertiary centres, at night only (OR, 1.20; 95% CI, 1.06-1.37). Similar significant effects were observed using the combined perinatal adverse outcome measure. Multilevel analysis was unsuccessful; extending the initial analysis with nominal hospital effects and hospital-delivery time interaction effects confirmed the significant effect of night in nontertiary hospitals, whereas other organisational effects (nontertiary, tertiary) were taken up by the hospital terms.Conclusion Hospital deliveries at night are associated with increased perinatal mortality and adverse perinatal outcome. The time of delivery and other organisational features representing experience (seniority of staff, volume) explain hospital-to-hospital variation.Keywords Adverse perinatal outcome, early neonatal mortality, intrapartum mortality, organisation of maternity units, seniority of staff, timing of hospital delivery, volume of deliveries.

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“…However, it has been shown that spontaneous onset of labor has a circadian rhythm in which the labor starts in the evening. And also the labor duration shortens as the labor contractions start in the evening [5]. Because of this, in late term pregnancies, starting induction of labor in the evening, coinciding with the circadian rhythm of natural birth, might be more beneficial for both mother and baby.…”

Section: Introductionmentioning

confidence: 99%

When Should the Labor Induction be Started For Late-term Pregnancies, in the Morning or in the Evening?

Kokanali¹,

Cavkaytar²,

Topçu³

et al. 2016

Ann Clin Anal Med

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ÖzetGiriş: Intravenöz oksitosin infüzyonu ile doğum indüksiyonu sabah ya da akşam başlatılan geç-term gebeliklerin sonuçlarını incelemek. Gereç ve Yöntem: Sefalik prezantasyonda tekil gebeliğe sahip, gebelik yaşı 41 0/7 haftadan 41 6/7 haftaya kadar olan 266 tane gebe bu retrospektif çalışmaya katılmıştır. İntravenöz oksiosin ile doğum indüksiyonları sabah saatlerinde (08.00-12.00) ya da akşam saatlerinde (16.00-20.00) başlatılmıştır. Doğum sonuçları ve gece saatlerindeki (20.00-08.00) doğumlar kaydedilmiştir. Bulgular: Primipar gebelerde, doğum eylemi süresi, doğum eyleminin aktif faz uzunluğu akşam grubunda sabah grubuna göre anlamlı olarak daha kısaydı. Multipar gebelerde, gece saatlerinde doğum oranı akşam grubunda sabah grubuna göre anlamlı derecede daha fazla idi. Ayrıca gece saatlerinde doğum, yenidoğan yoğun bakım ünitesine başvurmak için anlamlı bir risk faktörü olarak bulundu. Tartışma: İntravenöz oksitosin infüzyonu ile akşam başlatılan doğum indük-siyonu, primipar gebelerde doğum eylemi süresini kısaltırken multipar gebelerde kısaltmaz. Gece saatlerindeki doğum kötü perinatal sonuç için risk faktörü olabilir. Doğum indüksiyonu planlanırken, parite, indüksiyon başlama zamanı ve tahmini doğum saati olası kötü neonatal sonuçları azaltmak için dikkate alınmalıdır.Anahtar Kelimeler Doğum İndüksiyonu; Oksitosin; Sabah; Akşam Abstract Aim: We aimed to investigate the labor outcomes of late-term pregnancies underwent intravenous oxytocin induction starting in the morning compared with starting in the evening. Material and Method: 266 women with a singleton pregnancy in cephalic presentation, at gestational age of 41 0/7 through 41 6/7 weeks were enrolled in this retrospective study. Labor inductions with intravenous oxytocin were started in the morning hours (08.00-12.00) or in the evening hours (16.00-20.00). Labor outcomes and night-time (20.00-08.00) deliveries were recorded. Results: In primiparae group, labor duration and active phase length of labor were significantly shorter in the evening group than in the morning group. In multiparae women, the ratio of nighttime delivery was significantly higher in evening group as compared to morning group. And also night-time delivery was found as a significant risk factor for neonatal intensive care unit admission. Discussion: Induction of labour with intravenous oxytocin starting in the evening shortens labor duration in primiparae women, but not in multiparae women. Night-time delivery may be a risk for poor perinatal outcome. As the labor induction is planned, parity, start time of induction and estimated delivery time should be taken into account to reduce the risk of poor neonatal outcome in late-term pregnancies.

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The hour of birth: comparisons of circadian pattern between women cared for by midwives and obstetricians

Cited by 15 publications

References 17 publications

Biological Rhythms of Spinal-Epidural Labor Analgesia

Biological Rhythms of Spinal-Epidural Labor Analgesia

Increased adverse perinatal outcome of hospital delivery at night

When Should the Labor Induction be Started For Late-term Pregnancies, in the Morning or in the Evening?

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