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Master Thesis

Influence de l’heure d’accouchement sur le taux de césarienne dans une étude rétrospective de 2016 à 2019 au CHU de Caen

Abstract : Introduction: several authors have examined the impact of the time of delivery on the health of mother and child. Some have reported an increased risk of complications at night. This raises the issue of a possible heterogeneity of care strategy depending on the time slot. The main objective of our study was to assess the influence of time of delivery on the rate of cesarean sections. Materials and methods: this is a single-center, retrospective study. All deliveries after 24 SA at Caen University Hospital between 2016-2019 were analyzed except for scheduled cesarean sections and deliveries after fetal death and medical termination of pregnancy. The influence of the time of delivery on the cesarean section rate was evaluated by univariate and multivariate logistic regression over three periods: day (9:00 a.m. to 5:59 p.m.), evening (6:00 p.m. to 11:59 p.m.), night (00:00 a.m. to 8:59 a.m.). In addition, the rates of instrumental extractions and materno-neonatal complications were compared according to the three periods. Results: a total of 11,317 patients were included. The cesarean section rate was significantly lower at night (12.5%) than during the day (15.6%) (aOR 0.86 [0.75-0.99]). The NICU admission rate was 11.8% at night and 13.8% during the day. No difference was found in instrumental extractions, severe perineal injury, severe postpartum hemorrhage, pH, APGAR, or rate of neonatal death. Conclusion: delivery at night in our center is associated with a lower cesarean section rate. There is no difference in instrumental delivery rate. The results did not show any increased risk either maternal or neonatal over the night period.
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Submitted on : Thursday, September 9, 2021 - 3:55:09 PM
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Lisa Godet. Influence de l’heure d’accouchement sur le taux de césarienne dans une étude rétrospective de 2016 à 2019 au CHU de Caen. Médecine humaine et pathologie. 2021. ⟨dumas-03339701⟩



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