Akin Mustafa Senol, Cakir Ufuk
Neonatal Intensive Care Unit, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, 06800, Turkey.
J Trop Pediatr. 2024 Oct 4;70(6). doi: 10.1093/tropej/fmae049.
Staffing levels, fatigue, and intervention timing may vary based on working hours and potentially influence the clinical outcomes of newborns. It remains unclear how the birth time of premature infants throughout the day affects their clinical outcome. This study aimed to compare the clinical outcomes of premature infants born during and after work hours. In this single-center retrospective cohort study, infants born at <32 weeks of age were categorized into two groups based on birth time. The first group included infants born during daytime working hours on weekdays, whereas the second group included infants born during nighttime working hours on weekdays, weekends, and public holidays. Both groups were compared in terms of clinical outcomes. Data from 572 patients born at <32 weeks of age were analyzed, with 137 (24%) infants in the on-hours group and 435 (76%) in the off-hours group. No significant differences were observed between the groups in terms of gestational age (GA) (27.4 ± 2.8 weeks vs. 27.7 ± 2.7 weeks), birth weight (BW) (1132 ± 459 g vs. 1064 ± 450 g), and gender distribution (53.2% vs. 55.4% male) (P > .05). There were no significant differences in other clinical outcomes, morbidities, or mortality rates between the groups (P > .05). Despite potential fluctuations in neonatal intensive care unit (NICU) staffing levels during on- and off-duty hours, the morbidity and mortality of premature infants aged <32 weeks were not affected in our unit. Each NICU should assess whether delivery time influences clinical outcomes, based on unique care conditions. The change in clinical outcomes depending on the time of birth may be particularly important in low- and middle-income countries (LMIC). Negative results may be an indication that the staff is under excessive workload. In addition, by providing a solution to the cause of the detected problem, both clinical outcomes may be improved and patient care costs due to morbidity may be reduced. Our results may be particularly important for studies to be conducted on this subject in LMIC.
人员配备水平、疲劳程度和干预时机可能因工作时间而异,并可能影响新生儿的临床结局。目前尚不清楚早产儿一天中的出生时间如何影响其临床结局。本研究旨在比较工作时间内和工作时间后出生的早产儿的临床结局。在这项单中心回顾性队列研究中,孕周<32周出生的婴儿根据出生时间分为两组。第一组包括工作日白天工作时间出生的婴儿,而第二组包括工作日夜间工作时间、周末和公共假日出生的婴儿。比较两组的临床结局。分析了572例孕周<32周出生的患者的数据,工作时间组有137例(24%)婴儿,非工作时间组有435例(76%)婴儿。两组在胎龄(GA)(27.4±2.8周 vs. 27.7±2.7周)、出生体重(BW)(1132±459 g vs. 1064±450 g)和性别分布(男性分别为53.2%和55.4%)方面均无显著差异(P>.05)。两组在其他临床结局、发病率或死亡率方面也无显著差异(P>.05)。尽管新生儿重症监护病房(NICU)在值班和非值班时间的人员配备水平可能存在波动,但在我们科室,孕周<32周的早产儿的发病率和死亡率并未受到影响。每个NICU应根据独特的护理条件评估分娩时间是否会影响临床结局。在低收入和中等收入国家(LMIC),取决于出生时间的临床结局变化可能尤为重要。阴性结果可能表明工作人员工作量过大。此外,通过提供检测到问题的原因的解决方案,既可以改善临床结局,又可以降低因发病导致的患者护理成本。我们的结果对于在LMIC进行的关于该主题的研究可能尤为重要。