Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery

Objective:to determine whether planned route of delivery leads to differences in neonatal morbidity.study design:analysis was based on planned route of delivery, not actual route of delivery. a total of 4048 subjects were divided into two groups: planned vaginal delivery and planned cesarean delivery. primary outcomes were neonatal intensive care unit (nicu) admission, respiratory morbidity and neurologic morbidity.result:there were 3868 planned vaginal and 180 planned cesarean deliveries. planned vaginal delivery had decreased nicu admission (p<0.0001), oxygen resuscitation (p=0.001) and jaundice (p<0.0001) but increased meconium passage (p<0.0001) and 1 min apgar ⩽5 (p=0.02). after multivariable regression, nicu admission remained lower and meconium passage remained higher in the planned vaginal group.conclusion:planned vaginal delivery led to more meconium passage and low 1 min apgar but less nicu admissions, oxygen resuscitation and jaundice. multicenter trials are needed to assess rare but serious outcomes based on planned route of delivery.