Transactions of the Twenty-Sixth Annual Meeting of the Society for Maternal-Fetal MedicineThe MFMU Cesarean Registry: Impact of time of day on cesarean complications
Section snippets
Material and methods
Women undergoing an unscheduled cesarean delivery (CD) in 13 tertiary care teaching hospitals from 1999 to 2000 within a prospective observational study were included in this secondary analysis. The details of the original study from which the data were derived have been previously published.9 We included only term unscheduled cesareans because the day shift is more likely to have elective CDs, which are less likely to have complications and might skew the results. Term pregnancies were chosen
Results
There were 18,939 term patients delivered by unscheduled cesarean delivery during the study time period. Demographic and medical characteristics are seen in Table I. Characteristics do vary by shift of delivery. Though statistically significant, the differences seen appear to be of marginal clinical importance.
Even with a large sample size, there were no differences in maternal morbidity by shift (Table II). Multivariate analysis controlling for potential confounders found a slight reduction in
Comment
In this large multicenter observational study, we found no important differences in maternal or neonatal morbidity after unscheduled cesarean delivery according to work shift. This is in sharp contrast to the Gould study, which showed that neonatal outcomes were worse at night in the State of California.8 There are several possible explanations for our findings. (1) All obstetric teaching departments are required to have an attending physician on 24 hours a day. Many studies showing that errors
Acknowledgments
The authors would like to thank the following people for their contribution to the manuscript: protocol development and protocol/data management: Sharon Gilbert, MS; protocol development and coordination between clinical research centers: Frances Johnson, RN; and manuscript development: Brian M. Mercer, MD.
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Cited by (0)
Dr Bailit is supported by the Women's Reproductive Health Research (WRHR) Career Development Program; K12: HD98004.
Supported by grants from the National Institute of Child Health and Human Development (HD21410, HD21414, HD27860, HD27861, HD27869, HD27905, HD27915, HD27917, HD34116, HD34122, HD34136, HD34208, HD34210, and HD36801).
Dr Wapner is now with Columbia University, New York, NY. Dr Miodovnik is now with Washington Hospital Center, Washington, DC. Dr Sibai is now with University of Cincinnati, Cincinnati, OH. Dr Langer is now with St Luke's-Roosevelt Hospital Center, New York, NY.
Presented at the Twenty-Sixth Annual Meeting of the Society for Maternal Fetal Medicine, Miami, FL, January 30-February 4, 2006.
Other members of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network are listed in the Appendix.
Reprints not available from the authors.