Association between cesarean delivery and transition disorders in term and late preterm newborns: A prospective observational study
Introduction: Cesarean delivery (CS) has been associated with altered neonatal physiological transition due to the absence of labor-related hormonal and mechanical stimuli, which are essential for effective cardiopulmonary and metabolic adaptation after birth. Aim: To evaluate the association between cesarean delivery and early neonatal transition disorders in term and late preterm newborns. Methods: This prospective observational study included 230 newborns ≥ 35 weeks of gestation over a 12-month period. Infants were divided into CS (n = 100) and vaginal delivery (VD) groups (n = 130). Outcomes included respiratory disorders (TTN, RDS), need for respiratory support (CPAP/HFNC, oxygen therapy), NICU admission, as well as metabolic disturbances such as hypoglycemia. Results: Cesarean delivery was associated with significantly higher rates of TTN (28% vs 9%, p < 0.001) and RDS (12% vs 4%, p = 0.02). Infants in the CS group more frequently required CPAP/HFNC (22% vs 7%, p < 0.001), oxygen therapy (34% vs 12%, p < 0.001), and NICU admission (26% vs 10%, p < 0.001). Hypoglycemia was also more common following CS (18% vs 7%, p = 0.01). Conclusion: Cesarean delivery is associated with an increased risk of early neonatal transition disorders, particularly respiratory and metabolic complications. Optimizing the timing and indications for CS, along with structured postnatal monitoring, may reduce neonatal morbidity.