Early neonatal mortality, asphyxia related deaths, and timing of low risk births in Hesse, Germany, 1990-8: observational study
Babies born at night are almost twice as likely to die as babies born during the day, according to a study in this week's BMJ.
Researchers in Germany assessed the effect of night and day on death rates in over 380,000 low risk births born in clinics between 1990 and 1998. A total of 57 early deaths (during labour or within the first seven days of life) were found, reflecting the overall low risk of death of these births. However, babies born between 9pm and 6.59am - defined as night time births - were almost twice as likely to die as babies born at any other time. A clear link between time of birth and deaths related to asphyxia was also seen. These findings are almost identical to previously reported British results, say the authors, even allowing for some differences in the way the studies were conducted.
The authors suggest several explanations, such as staff's increased physical and mental fatigue during the night or over-reliance on less experienced staff during night shifts - a situation not specific to the NHS or the British population, they add. Better designed shifts, resulting in shorter working hours, or decreased workload with greater supervision by experienced staff at night, should be considered to reduce the risk of death during the night, they conclude.
Contact:
Gunther Heller, Assistant Professor, Medical Centre of Methodology and Health Research, Philipps-University of Marburg, Medical School, D 35033 Marburg, Germany Email: hellerg@mailer.uni-marburg.de