When Giving Birth, Beware Shift Changes
Dec. 6, 2001 -- In childbirth as in life, timing is everything. But when it comes to delivering a baby, timing is rarely under our control. A study in the Dec. 8 issue of the British Medical Journal suggests that babies born at night or during shift changes are at higher risk of early death, especially for premature births.
Researcher Johan Karlberg, MD, PhD, a professor and director of the Clinical Trials Centre at the University of Hong Kong, tells WebMD that his curiosity was piqued by an earlier German study reporting that babies born during the night were more likely to die in early life.
"We were interested to see if the same was true for Sweden," Karlberg says. "We confirmed the results of the German study, but we also found that babies delivered in the morning at around 8-9 o'clock had an increased risk of early mortality."
Using medical records from the Swedish birth register, Karlberg's group analyzed over 2 million births between 1973-1995 and found that infants born at night had a greater risk of dying in the first six days of life than those born during the day. Babies born between the hours of 5 p.m. and 1 a.m. and around 9 a.m. were at highest risk, suggesting that shift changes and the hours immediately after are the most dangerous.
During the period from 1990-1995, which showed a more dramatic difference than in earlier years, infants born at night had a 30% increased risk of early death, and premature infants had a 70% increased risk of death caused by lack of oxygen.
"The reason for the findings can only be speculated at this stage, but it may be due to management procedures or a variation in the background of staff on duty over the 24 hours," Karlberg says.
Excessive workloads, inadequate or less experienced staff on night shifts, or outdated systems for managing shift changes within hospitals could all worsen quality of care.
"This is a plausible explanation, but we must remain cautious in our interpretation," Douglas K. Richardson, MD, an associate professor of pediatrics at Beth Israel Deaconess Medical Center in Boston, tells WebMD.
When Giving Birth, Beware Shift Changes
Dec. 6, 2001 -- In childbirth as in life, timing is everything. But when it comes to delivering a baby, timing is rarely under our control. A study in the Dec. 8 issue of the British Medical Journal suggests that babies born at night or during shift changes are at higher risk of early death, especially for premature births.
Researcher Johan Karlberg, MD, PhD, a professor and director of the Clinical Trials Centre at the University of Hong Kong, tells WebMD that his curiosity was piqued by an earlier German study reporting that babies born during the night were more likely to die in early life.
"We were interested to see if the same was true for Sweden," Karlberg says. "We confirmed the results of the German study, but we also found that babies delivered in the morning at around 8-9 o'clock had an increased risk of early mortality."
Using medical records from the Swedish birth register, Karlberg's group analyzed over 2 million births between 1973-1995 and found that infants born at night had a greater risk of dying in the first six days of life than those born during the day. Babies born between the hours of 5 p.m. and 1 a.m. and around 9 a.m. were at highest risk, suggesting that shift changes and the hours immediately after are the most dangerous.
During the period from 1990-1995, which showed a more dramatic difference than in earlier years, infants born at night had a 30% increased risk of early death, and premature infants had a 70% increased risk of death caused by lack of oxygen.
"The reason for the findings can only be speculated at this stage, but it may be due to management procedures or a variation in the background of staff on duty over the 24 hours," Karlberg says.
Excessive workloads, inadequate or less experienced staff on night shifts, or outdated systems for managing shift changes within hospitals could all worsen quality of care.
"This is a plausible explanation, but we must remain cautious in our interpretation," Douglas K. Richardson, MD, an associate professor of pediatrics at Beth Israel Deaconess Medical Center in Boston, tells WebMD.