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Objectives To compare the composite neonatal and maternal adverse outcomes among women with diabetes who labor and deliver at 37–41 weeks at distinct time shifts. Methods This population-based retrospective cohort study using the US Vital Statistics dataset on Period Linked Birth-Infant Death Data from 2013–2017. The study population was restricted to non-anomalous singleton live births from women with pregestational or gestational diabetes, who labored and delivered at 37 0/7 to 41 6/7 weeks of gestation. The time of delivery was categorized as the first shift (7:00–15:00), the second shift (15:00–23:00), and the third shift (23:00–7:00). The primary outcome was a composite neonatal adverse outcome; the secondary outcome was a composite maternal adverse outcome. Multivariable Poisson regression models were used to estimate the association between the time of delivery and adverse outcomes (using adjusted relative risk [aRR] and 95% CI). Results Of 19.8 million live births during the study period, 3.3% (643,610) met the study inclusion criteria. The overall rate of composite neonatal and maternal adverse outcomes were 9.62 and 3.63 per 1000 live births, respectively. Multivariable adjusted regression analysis showed that, compared to newborns delivered at the first shift, the risk of composite neonatal adverse outcome was modestly but significantly higher (aRR 1.19, 95% CI 1.12–1.27) in the third shift (23:00–7:00). There was no significant difference in the risk of composite maternal adverse outcomes between time shifts. In the sensitivity analysis stratified by the day of the week (weekday vs weekend), the results were consistent with the primary analyses. Conclusion Among term pregnancies complicated by diabetes, compared with delivery at 7:00–15:00, the risk of a composite neonatal adverse outcome is marginally but significantly higher if delivery occurs at the third shift (23:00–7:00). [ABSTRACT FROM AUTHOR]

Introduction To determine the impact of route of delivery on maternal outcomes among individuals who deliver preterm (before 37 weeks). Materials and methods This was a population-based retrospective cohort study using the U.S. vital statistics datasets on Period Linked Birth-Infant Death Data from 2014 to 2018. The study population was restricted to live births from women with non-anomalous singletons who delivered at 24–36 weeks of gestation. The main explanatory variable for this study was route of delivery, which was categorized as: (i) vaginal delivery, (ii) cesarean delivery with labor, and (iii) cesarean delivery without labor. The primary outcome was composite maternal adverse outcome, which encompassed any of the following: admission to the intensive care unit, maternal blood transfusion, uterine rupture, or unplanned hysterectomy. The results were presented as adjusted relative risk (aRR) with 95% confidence interval (CI). Results Over the study period 1,440,510 live births met the inclusion criteria, and the overall composite maternal adverse outcome was 14.38 per 1,000 live births. After multivariable adjustment, compared to women who underwent a vaginal delivery, the risk of composite maternal adverse outcome was higher in women who had a cesarean delivery with labor (aRR 3.70; 95% CI 3.52–3.90) and those who had a cesarean delivery without labor (aRR 4.79; 95% CI 4.59–4.98). Conclusion With preterm birth, cesarean delivery without labor has higher rate of composite maternal morbidity than cesarean during labor or vaginal delivery. [ABSTRACT FROM AUTHOR]

Introduction: A potential manner to lower the morbidity with the hypertensive disoreders of pregancy is to explore the time of day of delivery.Objective: To compare composite neonatal adverse outcomes among term women with hypertensive disorders.Methods: This population-based cohort study used the U.S. vital statistics dataset from 2013 to 2017. Time of delivery was categorized into three shifts. The primary outcome was composite neonatal adverse outcome..Results: Compared to neonates delivered at the first shift, the risk of composite neonatal adverse outcome was higher at the third shift (aRR = 1.19, 95% CI = 1.13-1.25).Conclusion: the risk of composite neonatal adverse outcome is higher if the delivery occurs at the third (23:00-7:00) shift. [ABSTRACT FROM AUTHOR]