Background and aims After c-section term newborns are at risk of respiratory problems. Whereas some newborns require respiratory support only for a short time in the delivery room (DR), others are admitted to the NICU for prolonged therapy. Our aim was to compare differences between newborns with respiratory support in DR only and those admitted to the NICU.

Methods Retrospective analysis of video recorded DR-management of term newborns born between January 2012 and November 2013 via c-section.

Results 368 newborns were analysed with 82 (22%) receiving respiratory support. From them, 26 (32%) were transported to NICU for further treatment, the remaining 56 (68%) were stabilised after a short period of CPAP treatment. There were no demographic differences between both groups. CPAP-administration started after a median of 3.4 (0.2–27) in NICU and 3.7 (0.03–17) minutes in DR infants. At the start of CPAP administration infants had a median heart rate of 161 (75–195) in NICU and 153 (56–200) in DR newborns and SpO2 of 69 (41–100) and 80 (55–100) respectively (p = 0.01). 8 (31%) NICU and 15 (27%) DR newborns received a sustained inflation; mechanical ventilation via face-mask received 4 and 6 newborns respectively. In infants remaining in the DR respiratory support was stopped after a median of 7.6 (0.2–21) minutes, infants were transferred to the NICU after a respiratory support of 17.7 (4–29.6) minutes respectively.

Discussion Except for lower SpO₂ values there are no parameters to predict the need for the length of treatment in respiratory depressed term newborns.