Scholarlink

Background <p>Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Very preterm neonates born between 23 + 0 and 31 + 6 weeks of gestational age are at particularly high risk due to complications requiring immediate intervention. Whether the differential organization of healthcare services during working hours (full staffing) versus off-hours (on-call) affects neonatal outcomes remains debated. This study aims to evaluate the effect of in-hours versus off-hours birth timing on early morbidity and mortality in very preterm neonates.</p> Methods <p>This was a single-center, retrospective cohort study conducted in a tertiary neonatal intensive care unit between January 1, 2014 and December 31, 2021. A total of 326 very preterm neonates born between 23 + 0 and 31 + 6 weeks of gestational age were included. Neonates were divided into two groups according to birth timing: Group 1 (In-hours: 08:00–17:00 on weekdays) and Group 2 (Off-hours: 17:01–07:59 on weekdays, weekends, and public holidays). Demographic data and neonatal outcomes were compared between groups, and risk factors for mortality were examined using multivariate logistic regression analysis.</p> Results <p>No statistically significant difference was found between groups regarding gestational age, birth weight, or in-hospital mortality (Group 1: 25.3% vs. Group 2: 23.2%, <i>p</i> = 0.658). However, maternal risk factors such as gestational hypertension (<i>p</i> = 0.005) and placental insufficiency (<i>p</i> = 0.001) were significantly higher in the in-hours group. In multivariate analysis, low 5-minute Apgar scores and advanced-stage NEC (stage ≥ 3&#xa0;A) were identified as independent risk factors for mortality in both groups. Advanced-stage NEC showed a high odds ratio in both cohorts, though accompanied by wide confidence intervals due to small event sizes.</p> Conclusions <p>Birth timing (in-hours versus off-hours) had no significant effect on overall mortality or major morbidity in very preterm neonates, reflecting the continuity of care standards at our center. Advanced-stage NEC remained a critical predictor of mortality across both groups, independent of birth timing.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effect of birth timing on early morbidity and mortality in very preterm neonates: a single-center retrospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月16日

查看全文
  • Tuğçe L. Erdur,
  • Ahmet Erdur,
  • Betül A. Acunaş

摘要

Background

Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Very preterm neonates born between 23 + 0 and 31 + 6 weeks of gestational age are at particularly high risk due to complications requiring immediate intervention. Whether the differential organization of healthcare services during working hours (full staffing) versus off-hours (on-call) affects neonatal outcomes remains debated. This study aims to evaluate the effect of in-hours versus off-hours birth timing on early morbidity and mortality in very preterm neonates.

Methods

This was a single-center, retrospective cohort study conducted in a tertiary neonatal intensive care unit between January 1, 2014 and December 31, 2021. A total of 326 very preterm neonates born between 23 + 0 and 31 + 6 weeks of gestational age were included. Neonates were divided into two groups according to birth timing: Group 1 (In-hours: 08:00–17:00 on weekdays) and Group 2 (Off-hours: 17:01–07:59 on weekdays, weekends, and public holidays). Demographic data and neonatal outcomes were compared between groups, and risk factors for mortality were examined using multivariate logistic regression analysis.

Results

No statistically significant difference was found between groups regarding gestational age, birth weight, or in-hospital mortality (Group 1: 25.3% vs. Group 2: 23.2%, p = 0.658). However, maternal risk factors such as gestational hypertension (p = 0.005) and placental insufficiency (p = 0.001) were significantly higher in the in-hours group. In multivariate analysis, low 5-minute Apgar scores and advanced-stage NEC (stage ≥ 3 A) were identified as independent risk factors for mortality in both groups. Advanced-stage NEC showed a high odds ratio in both cohorts, though accompanied by wide confidence intervals due to small event sizes.

Conclusions

Birth timing (in-hours versus off-hours) had no significant effect on overall mortality or major morbidity in very preterm neonates, reflecting the continuity of care standards at our center. Advanced-stage NEC remained a critical predictor of mortality across both groups, independent of birth timing.