The MFMU Cesarean Registry: Impact of time of day on cesarean complications

Objective: Studies suggest that sleep deprivation adversely affects performance. We hypothesized that cesarean delivery complications would be more frequent during the night shift (I I PM-7 AM), and evaluated morbidities by delivery shift. Study design: Eighteen thousand nine hundred and thirty-nine term women undergoing an unscheduled cesarean delivery in 13 centers from 1999 to 2000 within a prospective observational study were included. Maternal/neonatal morbidities and time from decision to cesarean delivery were evaluated by time of delivery (7 AM-3 Pm, 3 PM-11 Pm, I I PM-7 AM). A composite of maternal morbidities was evaluated by logistic regression controlling for potentially confounding factors. Results: Controlling for age, race, insurance, cardiac disease, preeclampsia, diabetes, previous incision type, and prenatal care, shift of delivery had no impact on maternal morbidity (I I PM-7 AM OR 0.9 [95% CI 0.81-1.0]). NICU admissions were slightly increased at night but neonatal complications were not. Conclusion: Maternal and neonatal complications of cesarean delivery do not increase with delivery during the night shift. (c) 2006 Mosby, Inc. All rights reserved.