Catarci Stefano, Zanfini Bruno Antonio, Capone Emanuele, Di Muro Mariangela, Frassanito Luciano, Maddaloni Giovanni Maria, Lanzone Antonio, Draisci Gaetano
Department of Scienze Dell' Emergenza, Anestesiologiche e Della Rianimazione, IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy.
Department of Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy.
J Clin Med. 2024 Aug 27;13(17):5089. doi: 10.3390/jcm13175089.
: Variability in obstetric outcomes in terms of the number and type of deliveries related to the day-night cycle has been described in previous studies. This 11-year retrospective analysis explores the effects of nighttime versus daytime delivery with labor epidural on obstetric outcomes. : Data on deliveries performed between 1 October 2008 and 1 October 2019 were collected and differentiated into daytime, occurring from 8:00 a.m. to 7:59 p.m., and nighttime deliveries, occurring from 8:00 p.m. to 7:59 a.m. of the following day. The data collected included the patient history and maternal and neonatal outcomes. : A total of 29831 patients were included in the analysis. A positive and statistically significant correlation between the number of cesarean sections (Odds Ratio 1.35; 95% confidence interval = 1.26-1.44; < 0.001) and the number of vaginal operative deliveries (Odds Ratio 1.21; 95% confidence interval = 1.01-1.44; < 0.05) in patients who did not receive an epidural at nighttime was reported. Regarding the labor epidurals, a significantly greater incidence of accidental dural punctures with needles (0,4%; < 0.05) in the nighttime versus daytime was reported. : The absence of labor epidurals was associated with a significant increase in the number of cesarean sections and vaginal operative deliveries occurring at nighttime, without significant differences in labor duration. The incidence of anesthesiologic complications was greater in deliveries performed at nighttime.
以往研究已描述了与昼夜周期相关的分娩数量和类型方面产科结局的变异性。这项11年的回顾性分析探讨了夜间分娩与日间分娩并使用分娩硬膜外麻醉对产科结局的影响。
收集了2008年10月1日至2019年10月1日期间分娩的数据，并分为日间分娩（上午8:00至下午7:59）和夜间分娩（晚上8:00至次日上午7:59）。收集的数据包括患者病史以及母婴结局。
共有29831例患者纳入分析。结果显示，夜间未接受硬膜外麻醉的患者剖宫产数量（优势比1.35；95%置信区间=1.26 - 1.44；P<0.001）和阴道手术分娩数量（优势比1.21；95%置信区间=1.01 - 1.44；P<0.05）之间存在正相关且具有统计学意义。关于分娩硬膜外麻醉，报告显示夜间意外硬膜穿破的发生率（0.4%；P<0.05）显著高于日间。
未使用分娩硬膜外麻醉与夜间剖宫产和阴道手术分娩数量的显著增加相关，而产程无显著差异。夜间分娩的麻醉并发症发生率更高。
