Late-Preterm and Early-Term Respiratory Morbidity in Infants Born Primarily via Elective Caesarean Section
Abstract
1. Introduction
2. Materials and Methods
- Infants born at 34 to 38 + 6 weeks of gestation
- NICU admission
- Respiratory distress (any)
- Infants not fulfilling the above criteria
- Infants with congenital anomalies (such as trisomy, congenital heart disease, central nervous system anomaly, etc.)
- Infants with congenital infections
2.1. Ventilation Practice
2.2. Statistical Analysis
3. Results
3.1. Demographics
3.2. Analyses
Comparison of Ventilated and Non-Ventilated Infants
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| NICU | Neonatal Intensive Care Unit |
| UHP | University Hospital of Patras |
| CS | Cesarean Section |
| FiO2 | Fraction of Inspired Oxygen |
| PN | Parenteral Nutrition |
| IQR | Interquartile Range |
| RDS | Respiratory Distress Syndrome |
| ACOG | American College of Obstetrics and Gynecologists |
| FIGO | International Federation of Gynecology and Obstetrics |
| SPs | Surfactant Proteins |
| NA | Non-applicable |
| CO2 | Carbon Dioxide |
| aRR | adjusted risk ratio |
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| Clinical Characteristics (Prenatal, Perinatal) of Admitted Infants | Median (IQR) or n (%) |
|---|---|
| Maternal diabetes | 50 (23) |
| Maternal hypertension | 21 (10) |
| Intrauterine growth retardation | 20 (9) |
| Maternal age (years) | 31 (25–35) |
| Maternal smoking | 12 (5) |
| Antenatal corticosteroids | 104 (47) |
| Multiple pregnancy | 31 (14) |
| Outborn | 86 (39) |
| Cesarean Section | 196 (89) |
| Elective Cesarean Section | 144 (65) |
| Female sex | 79 (36) |
| Gestational age (weeks) | 35.8 (34.7–37.4) |
| Birth weight (kg) | 2.63 (2.25–3.04) |
| Birth weight (z-score) | −0.30 (−1.14–0.78) |
| Apgar score at 5 min | 9 (9–10) |
| Apgar score at 10 min | 10 (10–10) |
| Admission temperature (°C) | 36.6 (36.3–36.9) |
| Invasively ventilated | 88 (40) |
| Duration of ventilation (hours) | 1 (0–16) |
| Duration of non-invasive support (hours) | 1 (0–6) |
| Duration of supplemental oxygen (hours) | 10 (4–26) |
| Maximum required fraction of inspired oxygen (%) | 40 (30–47) |
| Duration of antibiotics (days) | 5 (3–7) |
| Duration of parenteral nutrition (days) | 3 (2–5) |
| Early-onset sepsis | 8 (3.6) |
| Late-onset sepsis | 33 (15) |
| Ventilated, n = 88 | Not Ventilated, n = 133 | p Value | |
|---|---|---|---|
| Maternal diabetes 1 | 21 (24) | 29 (22) | 0.869 |
| Maternal hypertension 1 | 12 (14) | 9 (7) | 0.091 |
| Intrauterine growth retardation 1 | 10 (11) | 10 (8) | 0.472 |
| Maternal age (years) 2 | 31 (7.5) | 31 (10.5) | 0.560 |
| Maternal smoking 1 | 5 (6) | 7 (5) | 1.000 |
| Antenatal corticosteroids 1 | 36 (41) | 68 (51) | 0.036 |
| Multiple pregnancy 1 | 8 (9) | 23 (17) | 0.112 |
| Outborn 1 | 36 (41) | 50 (38) | 0.673 |
| Cesarean Section 1 | 78 (89) | 118 (89) | 0.642 |
| Female sex 1 | 29 (33) | 50 (38) | 0.567 |
| Gestational age (weeks) 2 | 35 (2) | 36 (2.25) | 0.174 |
| Birth weight (kg) 2 | 2.660 (650) | 2.620 (930) | 0.230 |
| Birth weight (z-score) 2 | −0.32 (−1.18 to 0.75) | −0.28 (−1.10 to 0.78) | 0.685 |
| Apgar score at 5 min 2 | 9 (1) | 9 (1) | 0.897 |
| Apgar score at 10 min 2 | 10 (1) | 10 (1) | 0.151 |
| Admission temperature (°C) 2 | 36.6 (0.6) | 36.6 (0.5) | 0.844 |
| Duration of ventilation (hours) * | 19 (12–60) | - | NA |
| Duration of non-invasive support (hours) 2 | 0 (0–11) | 0 (0,0) | <0.001 |
| Duration of supplemental oxygen (hours) 2 | 76 (30–138) | 9 (4–23) | <0.001 |
| Maximum required fraction of inspired oxygen (%) 2 | 50 (40–60) | 35 (30–40) | <0.001 |
| Duration of antibiotics (days) 2 | 7 (5–7) | 3 (3–5) | <0.001 |
| Duration of parenteral nutrition (days) 2 | 4 (1–6) | 2 (1–3) | <0.001 |
| Late-onset sepsis 1 | 23 (26) | 10 (8) | <0.001 |
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Arvaniti, A.; Papachatzi, E.; Magriplis, E.; Antonakopoulos, N.; Antonakis, L.; Dimitriou, G.; Dassios, T. Late-Preterm and Early-Term Respiratory Morbidity in Infants Born Primarily via Elective Caesarean Section. J. Clin. Med. 2026, 15, 126. https://doi.org/10.3390/jcm15010126
Arvaniti A, Papachatzi E, Magriplis E, Antonakopoulos N, Antonakis L, Dimitriou G, Dassios T. Late-Preterm and Early-Term Respiratory Morbidity in Infants Born Primarily via Elective Caesarean Section. Journal of Clinical Medicine. 2026; 15(1):126. https://doi.org/10.3390/jcm15010126
Chicago/Turabian StyleArvaniti, Anthoula, Eleni Papachatzi, Emmanuella Magriplis, Nikolaos Antonakopoulos, Leonidas Antonakis, Gabriel Dimitriou, and Theodore Dassios. 2026. "Late-Preterm and Early-Term Respiratory Morbidity in Infants Born Primarily via Elective Caesarean Section" Journal of Clinical Medicine 15, no. 1: 126. https://doi.org/10.3390/jcm15010126
APA StyleArvaniti, A., Papachatzi, E., Magriplis, E., Antonakopoulos, N., Antonakis, L., Dimitriou, G., & Dassios, T. (2026). Late-Preterm and Early-Term Respiratory Morbidity in Infants Born Primarily via Elective Caesarean Section. Journal of Clinical Medicine, 15(1), 126. https://doi.org/10.3390/jcm15010126

