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The primary study outcome measure was neonatal death unrelated to congenital anomalies and a subgroup of deaths ascribed to intrapartum anoxia. The normal working week was defined as Monday to Friday, to hours; all other times were out of hours. A total of 0.
retrospect
The risk of neonatal death during the normal working week was 4. Adjustment for confounding effects of maternal characteristics did not change the results. The higher rate of neonatal death out of hours appeared to result from significant excess risk of death ascribed to intrapartum anoxia unadjusted OR, 1.
Exclusion of elective cesarean deliveries from the analysis attenuated the association between delivery out of hours and the risk of anoxia-related death, but the association persisted adjusted OR, 1. With exclusion of births by elective cesarean, the attributable fraction of neonatal deaths ascribed to intrapartum anoxia associated with delivery out of hours was These findings show that the risk of neonatal death at term ascribed to anoxia is increased among women delivering outside the hours of the normal working week.
The investigators suggest that the overall rates of perinatal death could be reduced by improving the level of clinical care for women delivering out of normal working hours.
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