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Night-time delivery linked to brain problems

Babies born late at night or in the wee hours of the morning have a slightly higher risk of rare brain problems compared to infants delivered during the day.

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Babies born late at night or in the wee hours of the morning have a slightly higher risk of rare brain problems compared to infants delivered during the day.

Previous studies have linked night-time births with greater risks of poor outcomes, including death. Decreased staffing and fatigue among doctors are often blamed. However, it has remained unclear whether the timing of the birth might play a role in neonatal encephalopathy.

Researchers studied nearly 1,864,766 million term babies born in California during a 14-year period to see whether the hour, day and month of delivery might impact the risk of the complication. Overall, they found that 2,131 babies, or about 1.1 per 1,000 births, had brain problems. Sixteen percent of these babies died before reaching 1 month of age. Babies born at night between the hours of 10 PM and 4 AM had a 22 percent higher risk than babies who were born during the day.

Also at a higher risk were boys and children of mothers who were over the age of 35 years, who had not received prenatal care, or who were giving birth for the first-time. Being born during the weekend, or during particular months of the year, did not change the risk of neonatal encephalopathy. There are rare cases in which the cause of neonatal encephalopathy is known, such as when the mother has severe bleeding of the placenta or a ruptured uterus. But in most cases, the underlying cause is unclear.

Consequently, the researchers cannot point to any specific means of prevention. But they do note some strategies that might help immediately after a baby is born with the condition. Cooling the baby's body temperature appears to protect the brain, and may lead to better long-term neurologic outcomes.

While it is possible that differing levels of health care quality during the day and night explain some of the differences, the researchers caution that their study does not prove that being born at night causes neonatal encephalopathy. The babies could be sharing something else that places them at higher risk than their daytime-born peers.

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