Erik A Jensen1, Scott A Lorch2. 1. Department of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, PA. Electronic address: jensene@email.chop.edu. 2. Department of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, PA; Center for Perinatal and Pediatric Health Disparities Research, The Children's Hospital of Philadelphia, Philadelphia, PA; Leonard Davis Institute of Health Economics, The Wharton School, The University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVE: To assess the independent association between overnight or "off-peak" hour delivery and 3 neonatal morbidities strongly associated with childhood neurocognitive impairment. STUDY DESIGN: Retrospective population based cohort study of all infants with birth weights of 500-1499 g born without severe congenital anomalies in California or Pennsylvania between 2002 and 2009. Off-peak hour delivery was defined as birth between 12:00 a.m. and 6:59 a.m. The study outcomes were death; bronchopulmonary dysplasia, retinopathy of prematurity, and severe (grade 3 or 4) intraventricular hemorrhage among survivors; the composite of each morbidity or mortality; and the composite of death or 1 or more of the evaluated morbidities. RESULTS: Of 47 617 evaluated infants, 9317 (19.6%) were born during off-peak hours. The frequencies of all study outcomes were higher among infants born during off-peak compared with peak hours. After adjusting for maternal, infant, and hospital characteristics, off-peak hour delivery was associated with increased odds of severe intraventricular hemorrhage among survivors (OR 1.39, 95% CI 1.23-1.57) and the composite outcomes of death or severe intraventricular hemorrhage (OR 1.16, 95% CI 1.07-1.25) and death or major morbidity (OR 1.08, 95% CI 1.02-1.15). There was no evidence of subgroup effects based on delivery mode, birth hospital neonatal intensive care level or annual very low birth weight infant delivery volume, or weekday vs weekend off-peak hour delivery for any study outcome. CONCLUSIONS: Very low birth weight infants born between midnight and 7:00 a.m. are at increased risk for severe intraventricular hemorrhage and death or major neonatal morbidity.
OBJECTIVE: To assess the independent association between overnight or "off-peak" hour delivery and 3 neonatal morbidities strongly associated with childhood neurocognitive impairment. STUDY DESIGN: Retrospective population based cohort study of all infants with birth weights of 500-1499 g born without severe congenital anomalies in California or Pennsylvania between 2002 and 2009. Off-peak hour delivery was defined as birth between 12:00 a.m. and 6:59 a.m. The study outcomes were death; bronchopulmonary dysplasia, retinopathy of prematurity, and severe (grade 3 or 4) intraventricular hemorrhage among survivors; the composite of each morbidity or mortality; and the composite of death or 1 or more of the evaluated morbidities. RESULTS: Of 47 617 evaluated infants, 9317 (19.6%) were born during off-peak hours. The frequencies of all study outcomes were higher among infants born during off-peak compared with peak hours. After adjusting for maternal, infant, and hospital characteristics, off-peak hour delivery was associated with increased odds of severe intraventricular hemorrhage among survivors (OR 1.39, 95% CI 1.23-1.57) and the composite outcomes of death or severe intraventricular hemorrhage (OR 1.16, 95% CI 1.07-1.25) and death or major morbidity (OR 1.08, 95% CI 1.02-1.15). There was no evidence of subgroup effects based on delivery mode, birth hospital neonatal intensive care level or annual very low birth weight infant delivery volume, or weekday vs weekend off-peak hour delivery for any study outcome. CONCLUSIONS: Very low birth weight infants born between midnight and 7:00 a.m. are at increased risk for severe intraventricular hemorrhage and death or major neonatal morbidity.
Authors: J P de Graaf; A C J Ravelli; G H A Visser; C Hukkelhoven; W H Tong; G J Bonsel; E A P Steegers Journal: BJOG Date: 2010-05-25 Impact factor: 6.531
Authors: Ciaran S Phibbs; Laurence C Baker; Aaron B Caughey; Beate Danielsen; Susan K Schmitt; Roderic H Phibbs Journal: N Engl J Med Date: 2007-05-24 Impact factor: 91.245
Authors: Sara C Handley; Molly Passarella; Tia T Raymond; Scott A Lorch; Anne Ades; Elizabeth E Foglia Journal: Resuscitation Date: 2021-06-06 Impact factor: 6.251
Authors: Wafa Sattam M Alotaibi; Nada S Alsaif; Ibrahim A Ahmed; Aly Farouk Mahmoud; Kamal Ali; Abdullah Hammad; Omar S Aldibasi; Saif A Alsaif Journal: Childs Nerv Syst Date: 2020-05-04 Impact factor: 1.475
Authors: Misun Yang; So Yoon Ahn; Heui Seung Jo; Se In Sung; Yun Sil Chang; Won Soon Park Journal: J Korean Med Sci Date: 2021-04-05 Impact factor: 2.153