Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Comparing cesarean section (CS) with vaginal delivery (VD) has different effects on the newborn's respiratory and metabolic health. This study was designed to compare respiratory and metabolic outcomes of neonatal birth, based on cesarean section and vaginal delivery, and investigate the differences according to the type of CS subtype (elective or emergency), where the study described was a cross-sectional cohort study conducted at Baghdad, Iraq, hospitals in 12 months between June 2024 and June 2025. The respiratory outcomes, metabolic outcomes, CS subtype (elective and emergency), NICU admission and overstay, and cord or first-hour arterial blood gas parameters were measured using this study. Results indicated that there was significantly more respiratory morbidity in CS (29.4% vs. 6.5% in VD), with TTN (23.5% vs. 4.8%) and an increased use of CPAP (11.8% vs. 1.6 evaluated) as causes and that metabolic disturbances were greater in VD with higher hypoglycemia in CS (23.5% vs. 8.1) and lower 2-hour mean glucose (53 vs. 62 mg/d Neonates of CS were more likely to be admitted to NICU (31.4% vs. 8.1) and spend longer time in hospitals (5.4 vs. 3.2 days). Cord blood gas analyses demonstrated a decrease in pH and an increase in PCOs₂ in CS, which was in line with an increase in respiratory compromise. In the CS group, elective CS registered numerical superior respiratory morbidity in comparison to emergency CS. The research finds that cesarean section is linked to the neonatal respiratory morbidity (TTN) and increased metabolic disturbance (reduced glucose at 2 hours and reduced glucose levels) in comparison to vaginal birth. In CS, there were overlapping patterns between elective and emergency subtypes with no distinct and statistically significant differences in the majority of outcomes, but elective CS was more likely to have respiratory morbidity.