Objective: To determine the impact of mode of delivery on neonatal outcomes in appropriately grown very to moderately preterm infants.

Materials and Methods:  A retrospective cohort study was performed of 190 singleton pregnant women who gave birth to an appropriately grown infant at 28⁺⁰–33⁺⁶ weeks of gestation in our institution between 2011 and 2014. The study group (n = 95) comprised women who had undergone cesarean delivery. The control group (n = 95) included those who had vaginal delivery. Both groups were matched 1:1 by gestational age at delivery. Neonatal outcomes were compared between the two groups. Multiple logistic regression analysis was used to determine the risk of neonatal complications.

Results:  Complete data of all 190 women were obtained. According to univariable analysis, cesarean delivery increased the risk of 5-minute Apgar score < 7 by threefold (95% confidence interval 1.12–8.06) compared to vaginal delivery. The risk remained significant after controlling for confounding factors (adjusted odds ratio = 4.33; 95% confidence interval 1.16–16.13). There were no significant differences between both groups in terms of respiratory distress, sepsis, intraventricular hemorrhage, seizure and neonatal death.

Conclusion:  In appropriately grown infants who were born at 28⁺⁰–33⁺⁶ weeks of gestation, cesarean delivery did not improve neonatal outcomes compared to vaginal delivery. On the other hand, it increased the risk of 5-minute Apgar score < 7.