{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:15:51Z","timestamp":1790853351808,"version":"4.1.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to evaluate the \u201coff-hour effect\u201d on maternal and neonatal adverse events in a large cohort representing U.S. population.<\/jats:p><jats:p>\n            Study Design\u2003A secondary analysis of the Consortium on Safe Labor (CSL) dataset with 208,695 women and 229,385 deliveries was performed. The study included the deliveries of \u226523 gestational weeks from 19 hospitals in the United States from 2002 to 2008. Babies with congenital anomalies were excluded from neonatal outcomes. We compared maternal and neonatal outcomes of patients delivered during weekdays versus off hours (nights and weekends). The primary outcomes of the study were composite maternal and composite neonatal adverse events. The secondary outcomes were delivery type and individual maternal and neonatal adverse events including maternal death and perinatal mortality rate. Associations between off hours and all the outcomes were analyzed in bivariable and multivariable analyses. The same analyses were performed in strata by indication for admission (spontaneous labor or induction of labor).<\/jats:p><jats:p>\n            Results\u2003Composite maternal adverse events (6.19 vs. 6.06%, p\u2009=\u20090.41) and maternal death (0.01 vs. 0.01%, p\u2009=\u20090.19) were not significantly different between off hours and weekday groups. In contrast, composite neonatal adverse events (6.91 vs. 5.84%, p\u2009&lt;\u20090.001) and perinatal mortality rate (1.03 vs. 0.77%, p\u2009&lt;\u20090.001) were higher in the off-hour group. After adjusting for confounding variables, only the composite neonatal outcome continued to be associated with off hours (adjusted odds ratio [aOR]\u2009=\u20091.10, 95% confidence interval [CI]: 1.04\u20131.16). Stratified analyses showed that the off-hour effect for the neonatal composite outcome was not present in those presenting in spontaneous labor (6.1 vs. 5.9%, p\u2009=\u20090.40).<\/jats:p><jats:p>\n            Conclusion\u2003Off-hour delivery was not associated with severe maternal morbidity and was only modestly associated with severe neonatal morbidity. This association was observed in women undergoing induction, not in those presenting in spontaneous labor. These data draw into question the existence of a clinically meaningful and correctable \u201coff-hour effect\u201d in obstetrics.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1740119","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T23:59:31Z","timestamp":1638489571000},"page":"089-097","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of \u201cOff Hours\u201d on Maternal and Perinatal Outcomes in a Diverse U.S. Cohort"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-0744","authenticated-orcid":false,"given":"Erol","family":"Arslan","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Health Sciences, Van Training and Research Hospital, Van\/Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett D.","family":"Einerson","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal Fetal Medicine, Intermountain Health Care, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ministry of Education, Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ministry of Education, Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Ware","family":"Branch","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal Fetal Medicine, Intermountain Health Care, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1136\/qshc.2008.028639","article-title":"Weekend mortality for emergency admissions. 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