Comparative analysis of blood gas parameters and apgar scores in normal vaginal delivery and cesarean section: A retrospective study

To compare Apgar scores and umbilical cord blood gas parameters between normal vaginal delivery (NVD) and cesarean section (C-section), and to evaluate their relationship in assessing immediate neonatal adaptation. This retrospective study included 604 neonates delivered between January 1, 2021 and December 31, 2022 at a tertiary care center. Infants were grouped according to mode of delivery (NVD: n=304; C-section: n=300). Apgar scores at 1 and 5 minutes and arterial cord blood gas parameters (pH, lactate, base deficit) were analyzed. Neonates with maternal or fetal comorbidities were excluded. Apgar scores were significantly higher in the NVD group at both 1 minute (7.71 ± 0.97 vs. 6.75 ± 1.47; p<0.001) and 5 minutes (8.92 ± 0.71 vs. 8.41 ± 0.96; p<0.001). Cord blood pH values did not differ significantly between groups (7.28 ± 0.05 vs. 7.27 ± 0.06; p=0.197). Among NVD neonates, those with Apgar ≥7 had significantly higher pH values compared with those with Apgar <7 (p=0.005). No significant correlations were detected between Apgar scores and lactate or base deficit in either group. NVD is associated with higher Apgar scores, indicating more favorable immediate neonatal adaptation compared with C-section. Despite this difference, cord blood gas parameters were comparable between groups, suggesting preserved acid–base homeostasis. These findings highlight the complementary value of Apgar scoring and blood gas analysis in the early assessment of neonatal well-being.