Transient tachypnea of the newborn: effects of labor and delivery type in term and preterm pregnancies

Abstract

Purpose

To determine whether timing or type of delivery affects the incidence of transient tachypnea of the newborn (TTN) in late preterm and term pregnancies.

Methods

The cases of 85 newborns delivered at Fatih University Hospital and diagnosed with TTN between January 2006 and March 2009 were reviewed. For every newborn with TTN, four infants who were not transferred to the neonatal intensive care unit (n = 340) were randomly selected and adjusted for year of delivery. Findings for delivery type (cesarean [CS] + labor, elective CS [ECS], vaginal), gestational age at delivery, and other relevant parameters were compared in the TTN and control groups.

Results

Forty-five (53%) of the 85 TTN newborns were premature and 73 (86%) were delivered by CS. Multivariate regression analysis identified male gender, CS delivery, lower gestational age, absence of PROM as risk factors for onset of TTN. In the CS + labor and ECS subgroups, the risk of TTN was significantly higher for babies delivered prior to 38 weeks’ gestation than for those delivered at 38 weeks or later (OR = 8.13 and 95%CI = 3.58–18.52 vs. OR = 7.14 and 95%CI = 2.81–18.18, respectively; p < 0.001 for both). However, there was no increased risk of TTN in either of these subgroups when babies delivered at 38 weeks’ gestation were compared with those delivered at ≥39 weeks (p > 0.05). At all gestational ages investigated in the study, infants delivered vaginally were less likely to develop TTN than those delivered via CS + labor or ECS.

Conclusions

Lower gestational age, CS delivery, and male sex are independent risk factors for TTN. Performing ECS no earlier than 38 weeks’ gestation may decrease the risk of TTN. Labor before CS is not sufficient to decrease the frequency of TTN, even after 37 weeks of gestation, whereas vaginal birth appears be protective against TTN.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Christian LH, Kevin NL (2007) Respiratory distress in the newborn. Am Fam Physician 76:987–994

    Google Scholar 

  2. 2.

    Dani C, Reali MF, Bertini G, Wiechmann L, Spagnolo A, Tangucci M et al (1999) Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Eur Respir J 14:155–159

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Zanardo V, Simbi AK, Franzoi M, Soldà G, Salvadori A, Trevisanuto D (2004) Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr 93:643–647

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Levine EM, Ghai V, Barton JJ, Strom CM (2001) Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 97:439–442

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, Moawad AH, Caritis SN, Meis PJ, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network et al (2009) Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med 360:111–120

    Google Scholar 

  6. 6.

    Jain L, Eaton DC (2006) Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol 30:34–43

    PubMed  Article  Google Scholar 

  7. 7.

    American Lung Association (2006) Respiratory distress syndrome of the newborn fact sheet. Accessed May 7, 2007, at: http://www.lungusa.org/site/pp.asp

  8. 8.

    Töllner U (1982) Early diagnosis of septicemia in the newborn. Clinical studies and sepsis score. Eur J Pediatr 138:331–337

    PubMed  Article  Google Scholar 

  9. 9.

    Kasap B, Duman N, Özer E, Tatli M, Kumral A, Özkan H (2008) Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 50:81–84

    PubMed  Article  Google Scholar 

  10. 10.

    Clark RH (2005) The epidemiology of respiratory failure in neonates born at an estimated gestational age of 34 weeks or more. J Perinatol 25:251–257

    PubMed  Article  Google Scholar 

  11. 11.

    Escobar GJ, Greene JD, Hulac P, Kincannon E, Bischoff K, Gardner MN et al (2005) Rehospitalisation after birth hospitalisation: patterns among infants of all gestations. Arch Dis Child 90:125–131

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Ronsmans C, Holtz S, Stanton C (2006) Socioeconomic differentials in caesarean rates in developing countries: a retrospective analysis. Lancet 28:1516–1523

    Article  Google Scholar 

  13. 13.

    Sheiner E, Vardi SI, Hershkovitz R, Katz M, Mazor M (2001) Infertility treatment is an independent risk factor for cesarean section among nulliparous women aged 40 and above. Am J Obstet Gynecol 185:888–892

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371:75–84

    PubMed  Article  Google Scholar 

  15. 15.

    Morrison J, Rennie JM, Milton PJ (1995) Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective cesarean section. Br J Obstet Gynaecol 102:101–106

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Hook B, Kiwi R, Amini SB, Fanaroff A, Hack M (1997) Neonatal morbidity after elective repeat cesarean section and trial of labor. Pediatrics 100:348–353

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Stockx EM, Pfister RE, Kyriakides MA, Brodecky V, Berger PJ (2007) Expulsion of liquid from the fetal lung during labour in sheep. Respir Physiol Neurobiol 157:403–410

    PubMed  Article  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Aysel Derbent.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Derbent, A., Tatli, M.M., Duran, M. et al. Transient tachypnea of the newborn: effects of labor and delivery type in term and preterm pregnancies. Arch Gynecol Obstet 283, 947–951 (2011). https://doi.org/10.1007/s00404-010-1473-6

Download citation

Keywords

  • Transient tachypnea
  • Elective cesarean delivery
  • Timing