Centre for Public Health Forecasting, National Institute for Public Health and the Environment, PO Box 1, Bilthoven, BA, 3720, The Netherlands.
BMC Pregnancy Childbirth. 2012 Sep 8;12:92. doi: 10.1186/1471-2393-12-92.
Studies have demonstrated a higher risk of adverse outcomes among infants born or admitted during off-hours, as compared to office hours, leading to questions about quality of care provide during off-hours (weekend, evening or night). We aim to determine the relationship between off-hours delivery and adverse perinatal outcomes for subgroups of hospital births.
This retrospective cohort study was based on data from the Netherlands Perinatal Registry, a countrywide registry that covers 99% of all hospital births in the Netherlands. Data of 449,714 infants, born at 28 completed weeks or later, in the period 2003 through 2007 were used. Infants with a high a priori risk of morbidity or mortality were excluded. Outcome measures were intrapartum and early neonatal mortality, a low Apgar score (5 minute score of 0-6), and a composite adverse perinatal outcome measure (mortality, low Apgar score, severe birth trauma, admission to a neonatal intensive care unit).
Evening and night-time deliveries that involved induction or augmentation of labour, or an emergency caesarean section, were associated with an increased risk of an adverse perinatal outcome when compared to similar daytime deliveries. Weekend deliveries were not associated with an increased risk when compared to weekday deliveries. It was estimated that each year, between 126 and 141 cases with an adverse perinatal outcomes could be attributed to this evening and night effect. Of these, 21 (15-16%) are intrapartum or early neonatal death. Among the 3100 infants in the study population who experience an adverse outcome each year, death accounted for only 5% (165) of these outcomes.
This study shows that for infants whose mothers require obstetric interventions during labour and delivery, birth in the evening or at night, are at an increased risk of an adverse perinatal outcomes.
与办公时间相比，研究表明，在非办公时间（周末、晚上或夜间）出生或住院的婴儿发生不良结局的风险更高，这引发了对非办公时间（周末、晚上或夜间）提供的护理质量的质疑。我们旨在确定非办公时间分娩与医院分娩亚组不良围产结局之间的关系。
本回顾性队列研究基于荷兰围产期登记处的数据，该登记处覆盖了荷兰所有医院分娩的 99%。使用了 2003 年至 2007 年间出生于 28 周或以上的 449714 名婴儿的数据。排除了事先存在高发病率或死亡率风险的婴儿。结局指标为产时和新生儿早期死亡率、低 Apgar 评分（5 分钟评分 0-6）和复合不良围产结局指标（死亡率、低 Apgar 评分、严重出生创伤、入住新生儿重症监护病房）。
与类似的白天分娩相比，夜间和夜间分娩时涉及引产或催产、紧急剖宫产与不良围产结局风险增加相关。与工作日分娩相比，周末分娩与不良围产结局风险增加无关。据估计，每年有 126-141 例不良围产结局可归因于这种夜间和夜间效应。其中，21 例（15-16%）为产时或新生儿早期死亡。在研究人群中每年经历不良结局的 3100 名婴儿中，死亡仅占这些结局的 5%（165）。
本研究表明，对于需要在分娩和分娩期间进行产科干预的母亲所生的婴儿，如果在晚上或夜间分娩，其不良围产结局的风险增加。
