1Assistant Professor, Department of Pediatrics, Pratima Relief Institute of Medical Sciences, Warangal, Telangana
2Professor, Department of Pediatrics, SMS&R, Sharda University
3*Associate Professor, Department of Pediatrics, SMS&R (Corresponding Author)
4Professor, Department of Pediatrics, SMS&R, Sharda University
Background: Cesarean sections have risen worldwide, and elective cesarean deliveries (ECD) done without medical indication—especially before 39 weeks—are linked to higher neonatal respiratory morbidity, NICU admissions, and early neonatal mortality. This study examined the magnitude and determinants of immediate adverse neonatal outcomes among neonates born by LSCS at a tertiary center in North India.
Materials and Methods: In this cross‑sectional study conducted from March 2021 to June 2022, 151 neonates delivered by LSCS were enrolled after excluding vaginal deliveries, intrauterine deaths, gestational age <28 weeks, birth weight <1000 g, and multifetal pregnancies. Data collected included APGAR scores, respiratory and cardiovascular status, neurological reflexes, birth trauma, time to first breastfeeding, and NICU admission and duration. Statistical analyses used Chi‑square tests and Pearson's correlation; p<0.05 was considered significant.
Results: Immediate adverse outcomes occurred in 30% of neonates; no neonatal deaths were noted within 24 hours. NICU admission was required in 30% (n=45), predominantly for respiratory distress. Admission rates varied significantly by gestational age: <34 weeks 100%, 34–37 weeks 33.3%, >37 weeks 18.9% (p=0.000). Prolonged NICU stay (>24 hours) was significantly more common at lower gestational ages (p=0.000). Delayed initiation of breastfeeding beyond 1 hour occurred in 65% overall and was strongly associated with lower gestational age (p=0.000). Maternal conditions such as eclampsia, pre‑eclampsia, and gestational diabetes showed higher NICU admissions but lacked statistical significance.
Conclusion: Prematurity, rather than mode of delivery alone, was the main driver of elevated NICU admissions and longer stays. Among neonates ≥34 weeks, many admissions were brief, suggesting transient respiratory issues. The high rate of delayed breastfeeding initiation after LSCS underscores the need for targeted supportive measures. Regional data can inform counseling, timing of elective procedures, and neonatal care planning.
Keywords: elective cesarean deliveries, NICU admissions, APGAR scores, neonatal morbidity, prematurity, transient tachypnea of the newborn, breastfeeding initiation
How to cite this article: Dr. Mothe Siddharth Reddy, Dr. Bindu T Nair, Dr. Praneta Swarup, Dr. Shashi Bhushan; Magnitude and determinants of immediate adverse neonatal outcomes among babies born by lower segment caesarean section: Int J Drug Deliv Technol. 2026; 16(5s): 937-942; DOI: 10.25258/ijddt.16.5s.115
Source of support: Nil.
Conflict of interest: Nil.