Elective caesarean delivery adversely affects preductal oxygen saturation during birth transition

Objective To compare preductal oxygen saturation (SpO 2 ), heart rate (HR) and cord blood pH after birth in healthy term neonates delivered by elective caesarean delivery (CD) and vaginal delivery (VD), managed according to 2010 Neonatal Resuscitation Guidelines. Design In a prospective cohort study, sensors were placed on the right hand of the neonate. Setting III level Maternity ward of the Department of Obstetrics and Gynaecology of Padua University, Padua, Italy. Main outcome measures SpO 2 and HR were recorded during the first 10 min after birth. Umbilical artery blood gas analysis was obtained immediately after delivery. Patients We studied 60 newborn infants by elective CD and 60 by VD. Results The SpO 2 gradually significantly improved during the first 10 min of life (p 2 (s=−2.44; 95% CI −4.52 to −0.36; p=0.02) with respect to VD. Conversely, at 10th minute, delivery mode had no statistically significant effect on HR (s=0.33; 95% CI −9.39 to 10.01; p=0.95). Conclusions In healthy term neonates, the SpO 2 gradually improved during the first 10 min of life. At 10th minute, elective CD had a significantly negative effect on SpO 2 , but these changes did not result in an impaired HR pattern.