Influence of Mode of Delivery on Umbilical Cord Blood Gas Parameters in Neonates: A Cross-Sectional Analysis

Authors

  • Inayat Ullah
  • Zeeshan Ahmed
  • Hakim Ullah Wazir
  • Liaqat Zaib
  • Mujahid Anwar Jadoon

Keywords:

Mode of delivery, Umbilical cord blood gases, Apgar score, Gestational age, Neonate

Abstract

Background: Umbilical cord blood gas analysis provides an objective assessment of the neonatal acid–base status at birth and may reflect the impact of intrapartum factors. The mode of delivery has been suggested to influence these parameters; however, findings remain inconsistent.

Objective: To evaluate the association between mode of delivery and umbilical artery blood gas parameters in term neonates.

Methods: This cross-sectional study was conducted in the Department of Neonatology, Pak-Emirates Military Hospital, Rawalpindi, affiliated with the National University of Medical Sciences, from August 2020 to January 2021. A total of 102 live, singleton term neonates delivered either by spontaneous vaginal delivery (SVD) or elective lower segment cesarean section (LSCS) were included. Neonates delivered via SVD were assigned to Group A, while those delivered by elective LSCS were assigned to Group B. Umbilical artery blood samples were obtained immediately after birth and analyzed for blood gas parameters. Comparisons between groups were performed accordingly.

Results: The mean maternal age was 29.51 ± 7.37 years. Of the 102 neonates, 45 (44.1%) were delivered by SVD and 57 (55.9%) by elective LSCS. Maternal characteristics did not differ significantly between the two groups (p > 0.05). An Apgar score ≥7 at 1 minute was observed in 60 (58.8%) neonates, while an Apgar score ≥8 at 5 minutes was noted in 72 (70.6%). All umbilical artery blood gas parameters showed statistically significant differences between the two delivery modes (p < 0.05).

Conclusion: Although umbilical cord blood gas values remained within the physiological range in both groups, significant variations were observed according to the mode of delivery. These findings suggest that the mode of delivery may influence neonatal acid–base status at birth.

Downloads

Download data is not yet available.

References

[1] Gillam-Krakauer M, Shah M, Gowen Jr CW. Birth Asphyxia. 2024 Oct 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 28613533.

[2] Moshiro R, Mdoe P, Perlman JM. A Global View of Neonatal Asphyxia and Resuscitation. Front Pediatr. 2019 Nov 26;7:489. doi: 10.3389/fped.2019.00489. PMID: 31850287; PMCID: PMC6902004.

[3] Bhatia P, Chhabra S. Physiological and anatomical changes of pregnancy: Implications for anaesthesia. Indian J Anaesth. 2018;62(9):651-657.

[4] Vesoulis ZA, Liao SM, Rao R, Trivedi SB, Cahill AG, Mathur AM. Re-examining the arterial cord blood gas pH screening criteria in neonatal encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2018;103(4):F377-F382.

[5] Loh SF, Woodworth A, Yeo GS. Umbilical cord blood gas analysis at delivery. Singapore Med J 1998;39(4):151-5.

[6] Chen Y, Liu W, Gong X, Cheng Q. Comparison of effects of general anesthesia and combined spinal/epidural anesthesia for cesarean delivery on umbilical cord blood gas values: A double-blind, randomized, controlled Study. Med Sci Monit. 2019;25:5272-9.

[7] Betrán AP, Merialdi M, Lauer JA, Bing‐Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98–113.

[8] Chen H, Tan D. Cesarean section or natural childbirth? Cesarean birth may damage your health. Front Psychol. 2019;10:351.

[9] Reynolds F. The effects of maternal labor analgesia on the fetus. Best Pract Res Clin Obstet Gynaecol 2010;24(3):289-302.

[10] Alehagen S, Wijma K, Lundberg U, Melin B, Wijma B. Catecholamine and cortisol reaction to childbirth. Int J Behav Med. 2001;8(1):50–65.

[11] Dudenhausen JW, Luhr C, Dimer JS. Umbilical artery blood gases in healthy term newborn infants. Int J Gynaecol Obstet 1997;57(3):251-8.

[12] Rahimi R, Akbarian Z, Zahed Pasha Y, Haghshenas Mojaveri M. The Effect of mode of delivery on the umbilical artery pH. Caspian J Pediatr March 2016;2(1):113-7.

[13] Ratcliffe FM, Evans JM. Neonatal well-being after elective caesarean delivery with general, spinal, epidural anesthesia. Eur J Anesthesiol 1993;10(3):175-81.

[14] Pence S, Kocoglu H, Balat O, Balat A. The effect of delivery on umbilical arterial cord blood gases and lipid peroxides: comparison of vaginal delivery and cesarean section. Clin Exp Obstet Gynecol 2002;29(3):212-4.

[15] Jain K, Bhardwaj N, Sharma A, Kaur J, Kumar P. A randomized comparison of the effects of low-dose spinal or general anaesthesia on umbilical cord blood gases during caesarean delivery of growth-restricted foetuses with impaired Doppler flow. Eur J Anaesthesiol 2013;30(1):9-15.

[16] Ahmadpour-Kacho M, Asnafi N, Javadian M, Hajiahmadi M, Taleghani N. Correlation between Umbilical Cord pH and Apgar Score in High-Risk Pregnancy. Iran J Pediatr 2010;20(4):401-6.

[17] Zaigham, M., Helfer, S., Kristensen, K. H., Isberg, P. E., & Wiberg, N. (2020). Maternal arterial blood gas values during delivery: Effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood. Acta obstetricia et gynecologica Scandinavica, 99(12), 1674–1681

[18] Pérez MLM, Hernández Garre JM, Pérez PE. Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth. Front Pediatr. 2021;9:650555.

[19] Manomayangkul K, Siriussawakul A, Nimmannit A, Yuyen T, Ngerncham S, Reesukumal K. Reference Values for Umbilical Cord Blood Gases of Newborns Delivered by Elective Cesarean Section. J Med Assoc Thai. 2016;99(5):611-617.

[20] Kotaska K, Urinovska R, Klapkova E, Prusa R, Rob L, Binder T. Re-evaluation of cord blood arterial and venous reference ranges for pH, pO(2), pCO(2), according to spontaneous or cesarean delivery. J Clin Lab Anal. 2010;24(5):300-304.

[21] Labrecque L, Provençal M, Caqueret A, et al. Correlation of cord blood pH, base excess, and lactate concentration measured with a portable device for identifying fetal acidosis. J Obstet Gynaecol Can. 2014;36(7):598-604..

Downloads

Published

2026-04-09

How to Cite

1.
Ullah I, Ahmed Z, Wazir HU, Zaib L, Anwar Jadoon M. Influence of Mode of Delivery on Umbilical Cord Blood Gas Parameters in Neonates: A Cross-Sectional Analysis. J Neonatal Surg [Internet]. 2026 Apr. 9 [cited 2026 Apr. 9];15(1s):71-6. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10182

Issue

Vol. 15 No. 1s (2026): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.