title: Elective caesarean delivery adversely affects preductal oxygen saturation during birth transition.
abstract: OBJECTIVE
  To compare preductal oxygen saturation (SpO2), 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.
  
  
  METHODS
  In a prospective cohort study, sensors were placed on the right hand of the neonate.
  
  
  METHODS
  III level Maternity ward of the Department of Obstetrics and Gynaecology of Padua University, Padua, Italy.
  
  
  METHODS
  SpO2 and HR were recorded during the first 10 min after birth. Umbilical artery blood gas analysis was obtained immediately after delivery.
  
  
  METHODS
  We studied 60 newborn infants by elective CD and 60 by VD.
  
  
  RESULTS
  The SpO2 gradually significantly improved during the first 10 min of life (p<0.0001), with a trend towards a slower increase in caesarean-delivered neonates (p=0.09) (Friedman's two-way non-parametric analysis of variance (ANOVA)). Instead, HR varied during the first 10 min of life (p=0.001) without significant difference between the two delivery groups (p=0.41). Umbilical artery pH values were lower in VD (p=0.005). At 10th minute, elective CD had a significantly negative effect on SpO2 (ß=-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 (ß=0.33; 95% CI -9.39 to 10.01; p=0.95).
  
  
  CONCLUSIONS
  In healthy term neonates, the SpO2 gradually improved during the first 10 min of life. At 10th minute, elective CD had a significantly negative effect on SpO2, but these changes did not result in an impaired HR pattern.
authors.affiliation: Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Zanardo
authors.affiliation: Children and Women's Health Department, Padua University School of Medicine, Padua, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Dal Cengio
authors.affiliation: Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Matteo
authors.initials: M
authors.lastname: Parotto
authors.affiliation: Independent Statistician, Padua, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavallin
authors.affiliation: Children and Women's Health Department, Padua University School of Medicine, Padua, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Trevisanuto
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data; D009321:Natural Childbirth / Q000379:methods / Q000706:statistics & numerical data; D010092:Oximetry / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D013223:Statistics as Topic; D047929:Term Birth; D013997:Time Factors
keywords: Evidence Based Medicine; Resuscitation