Published: 2021-02-23

Impact of cesarean section on transient tachypnea of the newborn: a longitudinal study

Keziah Joseph, Bhargavi B., C. S. Jain, Dasaradha Rami Reddy


Background: Transient tachypnea of the new born is a benign condition. The aim of the study is to find any correlation between the mode of delivery and occurrence of transient tachypnea of newborn.

Methods: Study is proposed to assess the risk factor like caesarean section and its relationship with occurrence of TTN in term neonates and the clinical course of TTN cases admitted in Neonatal intensive care unit (NICU), Department of Pediatrics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana.

Results: During the study period, total number of deliveries in our hospital was 4576. Of 356 term neonates with respiratory distress admitted in NICU, the most common cause was found to be early onset sepsis i.e 168 of 356 cases accounting for 47.19%, followed by transient tachypnea of newborn i.e., 68 of 356 cases accounting for 19.10%.

Conclusions: The mode of delivery i.e caesarean section has a significant impact on transient tachypnea of newborn (TTN) with a relative risk of 3.78 compared to normal vaginal delivery. The majority of cases had mild respiratory distress and were relieved of symptoms within 3 days of hospital stay.


Transient tachypnoea of the newborn, Cesarean section, Respiratory distress, Newborn, Mode of delivery

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Armangil D, Yurdakök M, Korkmaz A, Yiğit S, Tekinalp G. Inhaled beta-2 agonist salbutamol for the treatment of transient tachypnea of the newborn. J Pediatr. 2011;159(3):398-403.

Stephen D, Kichlighter MD. Transient Tachypnea of Newborn. Maggio. 2008;6(2):1-6.

Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Am J Dis Child. 1966;111:380-85.

Fanaroff & Martins. Transient Tachypnea of Newborn. In: Neonatal – Perinatal Medicine; Diseases of Fetus and Infant. 8th Edition; vol 2.

Cloherty JP, Eichenwald EC, Hansen AR. In: Manual of Neonatal Care. Transient Tachypnea of Newborn. 7th edition.

Rawlings JS, Smith FR. Transient Tachypnea of Newborn; an analysis of Neonatal and Obstetric Risk Factors. Am J Dis Child. 1984;138:869-71.

Tuddehope DI, Smyth MH. Is "transient tachypnea of the newborn" always a benign disease? Report of six babies requiring mechanical ventilation. Aust Paediatr J. 1979;15:160-65.

Halliday HL, McLure G, McReid M. Transient tachypnea of the newborn: two distinct clinical entities? Arch Dis Child. 1981;56:322-25.

Guglani L, Lakshminrusimha S, Ryan RM, transient tachypnea of newborn. Pediatr Rev. 2008:e59-65.

Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard score, expanded to include extremely premature infants. J Pediatr. 1991;119:417-23.

Downes JJ, Vidyasagar D, Boggs TR Jr, Morrow GM 3rd. Respiratory distress syndrome of newborn infants. I. New clinical scoring system (RDS score) with acid--base and blood-gas correlations. Clin Pediatr (Phila). 1970;9(6):325-31.

Tutdibi E, Gries K, Bucheler M, Misselwitz B, Rolf L. Impact of Labor on Outcomes in Transient Tachypnea of the Newborn: Population-Based Study Pediatrics. 2010;125;577-83.

Usher RH, Allen AC, Mc Lean FH, Risk of RDS related to Gestational age, Route of Delivery & Maternal Diabetes. Am J Obstet Gynecol. 1971;111:826-39.

Demissie K, Marcella SW, Breckenridge MB. Maternal Asthma and Transient Tachypnea of Newborn. Pediatrics. 1998;102:84-90.

Takaya A, Igarashi M, Shima Y. Risk factors for Transient Tachypnea of Newborn in infants delivered vaginally at 37 weeks or later. J Nippon Med Sch. 2008;75:269-73.

Morrison JJ, Rennie JM, Milton PJ: neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective cesarean section. BJOG. 1995;102:101-06.

C. Dani, M.F. Reali, G. Bertini, L. Wiechmann. Italian Group of Neonatal Pneumology. Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Eur Respir J. 1999;14:155-59.

Oztekin O, Kalay S. Can we predict duration of respiratory support in transient tachypnea of newborn. Turk J Med Sci. 2012;42:1494-498.

Fedakar A, Aydogdu C. Clinical features of neonates treated in intensive care unit for respiratory distress. Turkish J pediatrics. 2011;53(2):177-79.

G C S Smith, A M Wood, I R White, J P Pell, A D Cameron, R Dobbie Neonatal respiratory morbidity at term and the risk of childhood asthma, Arch Dis Child. 2004;89:956-60.

F A Liston, V M Allen, C M O’Connell, K A Jangaard. Neonatal outcomes with caesarean delivery at term. Arch dis child fetal neonatal Ed. 2008;93:F176-182.

Mathur NB, Garg K, Kumar S. Respiratory distress in neonates with special reference to pneumonia. Indian Pediatr. 2002;39:529-37.

Hourani M, Ziade F, Rajab M. Timing of planned caesarean section and morbidities of the newborn. Am J Med Sci. 2011;3(10):465-68.

Luca RD, Boulvain M, Irion O, Berner M. Incidence of Early Neonatal Mortality and Morbidity After Late-Preterm and Term Cesarean Delivery. Pediatrics. 2009;123(e1064):2008-2407.

Riskin A, Abend-Weinger M, Kugelman. Cesarean section, gestational age and transient tachypnea of newborn: timing is the key. Am J Perinatol. 2005;22:377-82.