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American Journal of Epidemiology Vol. 135, No. 8: 936-952
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

The Circadian Rhythm of the Perinatal Mortality Rate in Switzerland

Christiane Ruffieux, Alfio Marazzi and Fred Paccaud

From the Institut Universitaire de Médicine sociale et préventive Bugnon 17, 1005 Lausanne, Switzerland

Reprint requests to Prof. F. Paccaud at this address

The authors examine the relation between the perinatal mortality rate (PMR), birth weight in four categories, and hour of birth throughout the week in Switzerland, using data on 672,013 births and 5,764 perinatal deaths recorded between 1979 and 1987. From Monday to Friday, the PMR follows a circadian rhythm with a regular increase from early morning to evening, with a peak for babies born between 7 and 8pm. This pattern of variation has two main components. The circadian rhythms for the proportion of births in the four weight categories and the PMR circadian rhythm for babies weighing more than 2.5 kg According to a cosinor model, which describes about 40% of the total variation in the PMR, the most important determinants are changes in the proportions of births Low birth weight increases toward the afternoon and night Mechanisms underlying the weight-specific timing of birth are discussed, including time selection of birth according to obstetric risks, the direct effect of neonatal and obstetric care, and chronobiologic behavior. Am J Epidemiol 1992;135:936–52.

birth rate; circadian rhythm; infant mortality; regression analysis


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