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Time of Delivery Contributes to Mortality and Morbidity in Preterm Infants

Tiina Teivaanmäki1, Lotta Hallamaa2, Krista Rantakari1

  • 1Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Neonatology
|September 27, 2023
PubMed

Insights

Birth timing impacts premature infant outcomes. Infants born on Fridays had lower mortality, while nighttime births were linked to higher risks of intraventricular hemorrhage and necrotizing enterocolitis.

Area of Science:

  • Neonatal intensive care
  • Perinatal medicine
  • Public health

Background:

  • Understanding the impact of birth timing on premature infants is crucial for effective neonatal care and resource allocation.
  • Previous research has highlighted the importance of birth timing in neonatal outcomes, but specific associations with mortality and morbidity require further investigation.

Purpose of the Study:

  • To investigate the association between the time of birth and early mortality and morbidity in preterm infants.
  • To analyze how different birth times (office hours, evening, nighttime) affect outcomes in very preterm infants.

Main Methods:

  • The study analyzed data from 1,610 infants with birthweight <1,500 g and gestational age <32+0/7 weeks.
  • Infants were stratified into three groups based on time of birth: office hours, evening, and nighttime.
  • Associations between birth timing and mortality/morbidity (intraventricular hemorrhage, necrotizing enterocolitis) were assessed.

Main Results:

  • Mortality was lowest for infants born on Fridays (6%) and highest on Mondays (13%).
  • Nighttime births were associated with increased odds of intraventricular hemorrhage (OR: 1.50) and necrotizing enterocolitis (OR: 2.11).
  • These associations were attenuated after adjusting for covariates.

Conclusions:

  • Friday deliveries peaked, potentially due to scheduled cesarean sections, and were associated with lower mortality.
  • Monday deliveries showed the highest mortality, possibly due to postponed high-risk procedures.
  • Higher risks of intraventricular hemorrhage and necrotizing enterocolitis in nighttime births may be linked to patient population differences.
Abstract

Keywords:
PrematurityResource allocationTime of delivery

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