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

Am J Obstet Gynecol. 2006 Oct;195(4):1132-7. doi: 10.1016/j.ajog.2006.06.009. Epub 2006 Jul 26.


Objective: Studies suggest that sleep deprivation adversely affects performance. We hypothesized that cesarean delivery complications would be more frequent during the night shift (11 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, 11 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 (11 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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Morbidity
  • Pregnancy
  • Registries*
  • Time Factors
  • Work Schedule Tolerance*