Babies born during shift changes are at higher risk of early death

December 06, 2001

Timing of birth and infant and early neonatal mortality in Sweden 1973-95: longitudinal birth register study BMJ Volume 323, pp 1327-30

Babies born between the hours of 5pm to 1am and around 9am are at higher risk of early death, suggesting that shift changes and the hours immediately after are high risk periods for neonatal care, finds a study in this week's BMJ.

Using data from the Swedish birth register, researchers in Hong Kong analysed over 2 million births between 1973-95.

Their observations confirm previous reports that infants born at night have a greater risk of early death (in the first six days) than those born during the day. They also found that there has been no improvement over the past two decades, and that this problem is much more serious for preterm infants. The causes are not clear, but may be due to excess workloads, inadequate or less experienced staff on night shifts, or out of date systems for managing shift changes within hospitals, they suggest.

A more in depth analysis over 24 hours showed that there were actually two high risk periods for neonatal care: 5pm to 1am and around 9am. The first risk period started from the end of the normal day shift and extended to the midnight shift. The second one, around 9am, was immediately after day shift staff were taking over responsibilities. This pattern indicates that shift changes and the hours immediately after are high risk periods for neonatal care, say the authors.

The exact reasons are unclear, but better vigilance and an improvement in shift changes may be required to improve neonatal health care further, they conclude.


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