Multiple studies have identified birth outside regular working hours as an independent risk factor for neonatal death. An increased incidence of birth asphyxia has been implicated as the most likely causal mechanism. Although birth asphyxia can cause adverse neurodevelopmental and educational outcomes among survivors, long term implications of birth outside regular working hours are unknown. In a large national cohort of singleton births in Scotland, we studied whether birth during the evening/night or weekend was independently associated with additional support need (ASN) at school age.