Department of Neurology, University of California School of Medicine, San Francisco, 94117, USA.
Am J Obstet Gynecol. 2011 Jan;204(1):37.e1-6. doi: 10.1016/j.ajog.2010.09.022. Epub 2010 Nov 11.
The objective of the study was to determine the relationship between nighttime delivery and neonatal encephalopathy (NE).
The design of the study was a retrospective population-based cohort of 1,864,766 newborns at a gestation of 36 weeks or longer in California, 1999-2002. We determined the risk of NE associated with nighttime delivery (7:00 (PM) to 6:59 (AM)).
Two thousand one hundred thirty-one patients had NE (incidence 1.1 per 1000 births). Nighttime delivery was associated with increased NE (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.03-1.20), birth asphyxia (OR, 1.18; 95% CI, 1.08-1.29), and neonatal seizures (OR, 1.17; 95% CI, 1.07-1.28). In adjusted analyses, nighttime delivery was an independent risk factor for NE (OR, 1.10; 95% CI, 1.01-1.21), as were severe intrauterine growth retardation (OR, 3.8; 95% CI, 3.1-4.8); no prenatal care (OR, 2.0; 95% CI, 1.4-2.9); primiparity (OR, 1.5; 95% CI, 1.4-1.7); advanced maternal age (OR, 1.3; 95% CI, 1.16-1.45); and infant male sex (OR, 1.3; 95% CI, 1.2-1.4).
Future studies of time of delivery may generate new strategies to reduce the burden of NE.
本研究旨在探讨夜间分娩与新生儿脑病（NE）之间的关系。
本研究为回顾性基于人群的队列研究，纳入 1999 年至 2002 年加利福尼亚州 36 周或以上妊娠的 1864766 例新生儿。我们确定了夜间分娩（晚上 7 点至早上 6 点 59 分）与 NE 相关的风险。
2131 例患者患有 NE（发病率为每 1000 例出生 1.1 例）。夜间分娩与 NE 发生率增加相关（比值比 [OR]，1.13；95%置信区间 [CI]，1.03-1.20），与出生窒息（OR，1.18；95% CI，1.08-1.29）和新生儿癫痫发作（OR，1.17；95% CI，1.07-1.28）相关。在调整分析中，夜间分娩是 NE 的独立危险因素（OR，1.10；95% CI，1.01-1.21），严重宫内发育迟缓（OR，3.8；95% CI，3.1-4.8）；无产前保健（OR，2.0；95% CI，1.4-2.9）；初产妇（OR，1.5；95% CI，1.4-1.7）；高龄产妇（OR，1.3；95% CI，1.16-1.45）；以及婴儿男性性别（OR，1.3；95% CI，1.2-1.4）。
未来对分娩时间的研究可能会产生新的策略来降低 NE 的负担。
