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Perinatal neurologic deaths occur more often after night delivery.(Obstetrics)

OB GYN News

| April 01, 2005 | Finn, Robert | COPYRIGHT 2005 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

RENO, NEV. -- Newborn infants with neurologic injury resulting in death are twice as likely to have had a nighttime delivery as healthy infants, according to a study presented by Adam C. Urato, M.D., at the annual meeting of the Society for Maternal-Fetal Medicine.

The causes of this association are unclear, but may include prolonged labor, differences in staffing at night, and errors by medical personnel due to fatigue, said Dr. Urato of Tufts University, Boston.

The study made use of a Florida state database of perinatal neurologic injuries, created as a result of a law providing for no-fault compensation of families whose children suffer a birth-related neurologic injury.

Of the 447 cases of neurologic injury recorded from 1989 to 2002, there were 80 that resulted in the death of an infant. The database is limited to live-born children with brain or spinal cord injury whose birth weight was greater than 2,500 g. The neurologic problems were caused by oxygen deprivation or mechanical injury occurring in a hospital during labor, birth, delivery, or post delivery.

The 80 deaths were compared with a control group of 999 randomly selected births in Florida from 1996, the midpoint of the time span covered in the neurologic injury database, according to Dr. Urato.

Among the control group, 28% were born during the hours of 11 p.m. to 8 a.m. But 45% of the births with neurologic injury resulting in death occurred during those nighttime hours. Even after correcting the odds ratio for repeat cesarean deliveries, the deaths were 1.95 times more likely to occur at night, a statistically significant increase in risk.

Index cases were significantly less likely than controls to have been born via a normal spontaneous vaginal delivery (12.3% vs. ...

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