(Numbers of deaths related to intrapartum asphyxia and timing of birth in all Wales perinatal survey, 1993-5)
Deaths of babies around the time of their birth, although rare, seem to be more common at night and during months when annual leave is popular, suggest Stewart et al in this week's BMJ. The authors raise concerns about the variability of care around the time of delivery and from their study of 79 babies' deaths from birth asphyxia in Wales between 1993-5, the authors propose that errors of judgment are probably related to mental fatigue and so staff should be aware of how their performance may vary at different times. They indicate that mistakes may be mitigated with the greater use of shiftwork, but they stress that shifts need to be carefully designed to avoid the excessive disruption of circadian rhythms (upsetting the body clock) and consequent fatigue.
Stewart et al conclude that greater supervision by senior staff may be required at night and during summer months,
Dr Patrick Cartlidge, Senior Lecturer in Child Health, Department of Child health, university of Wales College of Medicine, Cardiff, Wales firstname.lastname@example.org