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Comparison of short-term neonatal hemodynamic and metabolic outcomes in preterm births by mode of delivery.

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Title: Comparison of short-term neonatal hemodynamic and metabolic outcomes in preterm births by mode of delivery.
Alternate Title: Comparación de los resultados hemodinámicos y metabólicos neonatales a corto plazo en nacimientos prematuros según el modo de parto.
Authors: Loorakagha, Amirmohammad1 amir_loorak@yahoo.com, Ashrafganjoei, Tahereh2 dr_tganjoei@sbmu.ac.ir, Mirzaei, Maryam3 m.mirzaei@kmu.ac.ir, Mansouri, Ghazal4 mansori@kmu.ac.ir, Shojaei, Fatemeh1 fatemeh.shojaei@kmu.ac.ir, Abedi, Somayeh5 midwifery.abedi42522@gmail.com, Dehghani, Aazam6 a.dehghani63@yahoo.com, Sohbati, Samira4 samira.sohbati@kmu.ac.ir
Source: Revista Latinoamericana de Hipertensión. 2025, Vol. 20 Issue 7, p488-496. 9p.
Subjects: PREMATURE infants, PREMATURE labor, RESPIRATORY distress syndrome, HIGH-risk pregnancy, PATENT ductus arteriosus, CESAREAN section, DELIVERY (Obstetrics)
Abstract (English): Introduction: Preterm birth remains a significant public health challenge due to the high risk of complications involving immature cardiopulmonary, renal, and metabolic systems. Despite various interventions, the optimal mode of delivery for preterm infants—particularly in relation to cardiovascular and hemodynamic stability—remains controversial. This study aimed to compare short-term neonatal outcomes following vaginal and cesarean deliveries in preterm births, with a focus on common complications related to circulatory, respiratory, and metabolic functions. Methods: This cohort study was conducted at Afzalipour Hospital in Kerman, Iran, between 2010 and 2018. Pregnant women with preterm labor were included and categorized based on mode of delivery: vaginal (n=425) and cesarean section (n=330). Each group was stratified by gestational age (≤24, 25–27, 28–30, 31–33, and 34–36 weeks). Key neonatal outcomes—including respiratory distress syndrome (RDS), hyperbilirubinemia, patent ductus arteriosus (PDA), ventilator dependence, and NICU admission—were recorded and analysed using SPSS-20. Results: The incidence of RDS (52.5% vs. 43.3%, p=0.02), neonatal jaundice (24.4% vs. 17.3%, p=0.03), and ventilator dependence (20.2% vs. 11.2%, p=0.01) was significantly higher in neonates delivered by cesarean section. Among appropriate-for-gestational-age (AGA) infants, PDA was less frequent following vaginal delivery (5.9% vs. 11.2%, p=0.01). NICU admission was significantly higher for AGA infants delivered by cesarean at 28–30 weeks (p=0.04) and for large-for-gestational-age (LGA) infants above 34 weeks (p=0.04). Conclusion: The findings suggest that vaginal delivery in preterm births may lead to more favourable early neonatal outcomes, particularly in terms of respiratory function, hemodynamic stability, and metabolic adaptation. These results can contribute to improved clinical decision-making for high-risk pregnancies, with a focus on optimising cardiovascular and systemic outcomes in premature newborns. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción y antecedentes. El parto prematuro sigue siendo un importante reto para la salud pública debido al alto riesgo de complicaciones que afectan a los sistemas cardiopulmonar, renal y metabólico inmaduros. A pesar de diversas intervenciones, la modalidad óptima de parto para los prematuros, en particular en relación con la estabilidad cardiovascular y hemodinámica, sigue siendo controvertida. Este estudio tuvo como objetivo comparar los resultados neonatales a corto plazo tras partos vaginales y cesáreas en prematuros, centrándose en las complicaciones comunes relacionadas con las funciones circulatoria, respiratoria y metabólica. Métodos. Este estudio de cohorte se realizó en el Hospital Afzalipour de Kermán, Irán, entre 2010 y 2018. Se incluyeron mujeres embarazadas con trabajo de parto prematuro, categorizadas según la vía de parto: vaginal (n = 425) y cesárea (n = 330). Cada grupo se estratificó por edad gestacional (≤24, 25-27, 28-30, 31-33 y 34-36 semanas). Los resultados neonatales clave, como el síndrome de dificultad respiratoria (SDR), la hiperbilirrubinemia, el conducto arterioso persistente (CAP), la dependencia del respirador y el ingreso en la UCIN, se registraron y analizaron mediante el programa SPSS-20. Resultados. La incidencia de SDR (52,5 % frente a 43,3 %, p = 0,02), ictericia neonatal (24,4 % frente a 17,3 %, p = 0,03) y dependencia de ventilación mecánica (20,2 % frente a 11,2 %, p = 0,01) fue significativamente mayor en los neonatos nacidos por cesárea. Entre los neonatos con edad gestacional adecuada (AEG), el DAP fue menos frecuente tras el parto vaginal (5,9 % frente a 11,2 %, p = 0,01). El ingreso en la UCIN fue significativamente mayor en los neonatos con edad gestacional adecuada (AEG) nacidos por cesárea entre las 28 y 30 semanas (p = 0,04) y en los neonatos grandes para la edad gestacional (GEG) mayores de 34 semanas (p = 0,04). Conclusión. Los hallazgos sugieren que el parto vaginal en partos prematuros puede conducir a resultados neonatales tempranos más favorables, especialmente en términos de función respiratoria, estabilidad hemodinámica y adaptación metabólica. Estos resultados pueden contribuir a una mejor toma de decisiones clínicas en embarazos de alto riesgo, con especial atención a la optimización de los resultados cardiovasculares y sistémicos en recién nacidos prematuros. [ABSTRACT FROM AUTHOR]
Copyright of Revista Latinoamericana de Hipertensión is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Comparison of short-term neonatal hemodynamic and metabolic outcomes in preterm births by mode of delivery.
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  Data: Comparación de los resultados hemodinámicos y metabólicos neonatales a corto plazo en nacimientos prematuros según el modo de parto.
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  Data: <searchLink fieldCode="AR" term="%22Loorakagha%2C+Amirmohammad%22">Loorakagha, Amirmohammad</searchLink><relatesTo>1</relatesTo><i> amir_loorak@yahoo.com</i><br /><searchLink fieldCode="AR" term="%22Ashrafganjoei%2C+Tahereh%22">Ashrafganjoei, Tahereh</searchLink><relatesTo>2</relatesTo><i> dr_tganjoei@sbmu.ac.ir</i><br /><searchLink fieldCode="AR" term="%22Mirzaei%2C+Maryam%22">Mirzaei, Maryam</searchLink><relatesTo>3</relatesTo><i> m.mirzaei@kmu.ac.ir</i><br /><searchLink fieldCode="AR" term="%22Mansouri%2C+Ghazal%22">Mansouri, Ghazal</searchLink><relatesTo>4</relatesTo><i> mansori@kmu.ac.ir</i><br /><searchLink fieldCode="AR" term="%22Shojaei%2C+Fatemeh%22">Shojaei, Fatemeh</searchLink><relatesTo>1</relatesTo><i> fatemeh.shojaei@kmu.ac.ir</i><br /><searchLink fieldCode="AR" term="%22Abedi%2C+Somayeh%22">Abedi, Somayeh</searchLink><relatesTo>5</relatesTo><i> midwifery.abedi42522@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Dehghani%2C+Aazam%22">Dehghani, Aazam</searchLink><relatesTo>6</relatesTo><i> a.dehghani63@yahoo.com</i><br /><searchLink fieldCode="AR" term="%22Sohbati%2C+Samira%22">Sohbati, Samira</searchLink><relatesTo>4</relatesTo><i> samira.sohbati@kmu.ac.ir</i>
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  Data: <searchLink fieldCode="JN" term="%22Revista+Latinoamericana+de+Hipertensión%22">Revista Latinoamericana de Hipertensión</searchLink>. 2025, Vol. 20 Issue 7, p488-496. 9p.
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  Data: <searchLink fieldCode="DE" term="%22PREMATURE+infants%22">PREMATURE infants</searchLink><br /><searchLink fieldCode="DE" term="%22PREMATURE+labor%22">PREMATURE labor</searchLink><br /><searchLink fieldCode="DE" term="%22RESPIRATORY+distress+syndrome%22">RESPIRATORY distress syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22HIGH-risk+pregnancy%22">HIGH-risk pregnancy</searchLink><br /><searchLink fieldCode="DE" term="%22PATENT+ductus+arteriosus%22">PATENT ductus arteriosus</searchLink><br /><searchLink fieldCode="DE" term="%22CESAREAN+section%22">CESAREAN section</searchLink><br /><searchLink fieldCode="DE" term="%22DELIVERY+%28Obstetrics%29%22">DELIVERY (Obstetrics)</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Introduction: Preterm birth remains a significant public health challenge due to the high risk of complications involving immature cardiopulmonary, renal, and metabolic systems. Despite various interventions, the optimal mode of delivery for preterm infants—particularly in relation to cardiovascular and hemodynamic stability—remains controversial. This study aimed to compare short-term neonatal outcomes following vaginal and cesarean deliveries in preterm births, with a focus on common complications related to circulatory, respiratory, and metabolic functions. Methods: This cohort study was conducted at Afzalipour Hospital in Kerman, Iran, between 2010 and 2018. Pregnant women with preterm labor were included and categorized based on mode of delivery: vaginal (n=425) and cesarean section (n=330). Each group was stratified by gestational age (≤24, 25–27, 28–30, 31–33, and 34–36 weeks). Key neonatal outcomes—including respiratory distress syndrome (RDS), hyperbilirubinemia, patent ductus arteriosus (PDA), ventilator dependence, and NICU admission—were recorded and analysed using SPSS-20. Results: The incidence of RDS (52.5% vs. 43.3%, p=0.02), neonatal jaundice (24.4% vs. 17.3%, p=0.03), and ventilator dependence (20.2% vs. 11.2%, p=0.01) was significantly higher in neonates delivered by cesarean section. Among appropriate-for-gestational-age (AGA) infants, PDA was less frequent following vaginal delivery (5.9% vs. 11.2%, p=0.01). NICU admission was significantly higher for AGA infants delivered by cesarean at 28–30 weeks (p=0.04) and for large-for-gestational-age (LGA) infants above 34 weeks (p=0.04). Conclusion: The findings suggest that vaginal delivery in preterm births may lead to more favourable early neonatal outcomes, particularly in terms of respiratory function, hemodynamic stability, and metabolic adaptation. These results can contribute to improved clinical decision-making for high-risk pregnancies, with a focus on optimising cardiovascular and systemic outcomes in premature newborns. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción y antecedentes. El parto prematuro sigue siendo un importante reto para la salud pública debido al alto riesgo de complicaciones que afectan a los sistemas cardiopulmonar, renal y metabólico inmaduros. A pesar de diversas intervenciones, la modalidad óptima de parto para los prematuros, en particular en relación con la estabilidad cardiovascular y hemodinámica, sigue siendo controvertida. Este estudio tuvo como objetivo comparar los resultados neonatales a corto plazo tras partos vaginales y cesáreas en prematuros, centrándose en las complicaciones comunes relacionadas con las funciones circulatoria, respiratoria y metabólica. Métodos. Este estudio de cohorte se realizó en el Hospital Afzalipour de Kermán, Irán, entre 2010 y 2018. Se incluyeron mujeres embarazadas con trabajo de parto prematuro, categorizadas según la vía de parto: vaginal (n = 425) y cesárea (n = 330). Cada grupo se estratificó por edad gestacional (≤24, 25-27, 28-30, 31-33 y 34-36 semanas). Los resultados neonatales clave, como el síndrome de dificultad respiratoria (SDR), la hiperbilirrubinemia, el conducto arterioso persistente (CAP), la dependencia del respirador y el ingreso en la UCIN, se registraron y analizaron mediante el programa SPSS-20. Resultados. La incidencia de SDR (52,5 % frente a 43,3 %, p = 0,02), ictericia neonatal (24,4 % frente a 17,3 %, p = 0,03) y dependencia de ventilación mecánica (20,2 % frente a 11,2 %, p = 0,01) fue significativamente mayor en los neonatos nacidos por cesárea. Entre los neonatos con edad gestacional adecuada (AEG), el DAP fue menos frecuente tras el parto vaginal (5,9 % frente a 11,2 %, p = 0,01). El ingreso en la UCIN fue significativamente mayor en los neonatos con edad gestacional adecuada (AEG) nacidos por cesárea entre las 28 y 30 semanas (p = 0,04) y en los neonatos grandes para la edad gestacional (GEG) mayores de 34 semanas (p = 0,04). Conclusión. Los hallazgos sugieren que el parto vaginal en partos prematuros puede conducir a resultados neonatales tempranos más favorables, especialmente en términos de función respiratoria, estabilidad hemodinámica y adaptación metabólica. Estos resultados pueden contribuir a una mejor toma de decisiones clínicas en embarazos de alto riesgo, con especial atención a la optimización de los resultados cardiovasculares y sistémicos en recién nacidos prematuros. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Revista Latinoamericana de Hipertensión is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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