{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:00:40Z","timestamp":1784815240329,"version":"3.55.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Evidence on neonatal consequences of scheduling elective caesarean section before 39 completed weeks is limited in Palestine. We evaluated neonatal outcomes by delivery mode and gestational timing in two hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used records from Al-Makassed Charitable Hospital, Jerusalem, and Al-Ahli Hospital, Hebron, from January 2021 to December 2024. Liveborn singleton infants delivered at 34\u2009+\u20090 weeks or later were included and grouped as elective caesarean section late preterm, elective caesarean section early term, non-assisted spontaneous vaginal delivery late preterm, non-assisted spontaneous vaginal delivery early term, or elective caesarean section at 39\u2009+\u20090 weeks or later. The primary outcome was composite neonatal morbidity. Multivariable logistic regression adjusted for neonatal, maternal, and hospital covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8,364 infants, 3,347 were delivered by elective caesarean section; 2,569 (76.8%) occurred before 39 weeks. Composite morbidity was highest after late-preterm elective caesarean section (49.0%), followed by late-preterm vaginal birth (28.2%), early-term elective caesarean section (26.6%), elective caesarean section at 39 weeks or later (15.3%), and early-term vaginal birth (13.9%). Late-preterm elective caesarean section was independently associated with NICU admission, respiratory support, transient tachypnoea, respiratory distress syndrome requiring surfactant, hyperbilirubinaemia requiring treatment, and composite morbidity. Early-term elective caesarean section remained associated with composite morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this multicentre retrospective cohort, planned prelabour caesarean delivery before 39+0 weeks was associated with higher early neonatal morbidity, especially when performed in the late-preterm period. Because some late-preterm and early-term planned caesarean births may be medically indicated, these findings should be interpreted as support for careful documentation, senior review, and avoidance of non-medically indicated pre-39-week scheduling rather than as evidence that all earlier planned caesarean births should be deferred.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1874317","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:50:33Z","timestamp":1782280233000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gestational timing and early neonatal outcomes in Palestine: a multicentre retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Motee","family":"Abuawwad","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]},{"name":"Department of Neonatology, Makassed Charitable Hospital","place":["Jerusalem, Palestine"]},{"name":"Department of Neonatology, Al-Ahli Hospital","place":["Hebron, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ibrahim","family":"Ghannam","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Makassed Charitable Hospital","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salahaldeen","family":"Deeb","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa Rashed Naji","family":"Said","sequence":"additional","affiliation":[{"name":"Al-Ahli Hospital","place":["Hebron, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Taqatqah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]},{"name":"Medical Research Club, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Joulani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]},{"name":"Medical Research Club, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayan Abed","family":"Rabu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]},{"name":"Medical Research Club, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala","family":"Dwaib","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deema","family":"Alzeer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salwa Sheikh","family":"Kasem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatem Mousa","family":"Khamash","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asmaa A.","family":"Rjoob","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]},{"name":"Al-Ahli Hospital","place":["Hebron, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e005671","DOI":"10.1136\/bmjgh-2021-005671","article-title":"Trends and projections of caesarean section rates: global and regional estimates","volume":"6","author":"Betran","year":"2021","journal-title":"BMJ Glob Health"},{"key":"B2","volume-title":"WHO statement on Caesarean Section Rates","year":"2015"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e156","DOI":"10.1097\/AOG.0000000000003074","article-title":"Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities: ACOG committee opinion No. 765","volume":"133","year":"2019","journal-title":"Obstet Gynecol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e35","DOI":"10.1097\/AOG.0000000000004447","article-title":"Medically indicated late-preterm and early-term deliveries: ACOG committee opinion No. 831","volume":"138","year":"2021","journal-title":"Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1097\/01.AOG.0000437385.88715.4a","article-title":"Definition of term pregnancy: ACOG committee opinion No. 579","volume":"122","year":"2013","journal-title":"Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e150","DOI":"10.1097\/AOG.0000000000002046","article-title":"Methods for estimating the due date: aCOG committee opinion No. 700","volume":"129","year":"2017","journal-title":"Obstet Gynecol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1186\/s12884-020-03036-1","article-title":"A systematic review and time-response meta-analysis of the optimal timing of elective caesarean sections for best maternal and neonatal health outcomes","volume":"20","author":"Prediger","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1056\/NEJMoa0803267","article-title":"Timing of elective repeat cesarean delivery at term and neonatal outcomes","volume":"360","author":"Tita","year":"2009","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3389\/fped.2020.00286","article-title":"Elective cesarean section on term pregnancies has a high risk for neonatal respiratory morbidity in developed countries: a systematic review and meta-analysis","volume":"8","author":"Tefera","year":"2020","journal-title":"Front Pediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e0249557","DOI":"10.1371\/journal.pone.0249557","article-title":"Timing of term elective cesarean section and adverse neonatal outcomes: a multi-center retrospective cohort study","volume":"16","author":"Al Bizri","year":"2021","journal-title":"PLoS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","article-title":"The strengthening the reporting of observational studies in epidemiology statement: guidelines for reporting observational studies","volume":"4","author":"von Elm","year":"2007","journal-title":"PLoS Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ajog.2017.04.016","article-title":"Confounding, causality, and confusion: The role of intermediate variables in interpreting observational studies in obstetrics","volume":"217","author":"Ananth","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1056\/NEJMoa1516783","article-title":"Antenatal betamethasone for women at risk for late preterm delivery","volume":"374","author":"Gyamfi-Bannerman","year":"2016","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"CD006614","DOI":"10.1002\/14651858.CD006614.pub4","article-title":"Antenatal corticosteroids prior to planned caesarean at term for improving neonatal outcomes","volume":"12","author":"Sotiriadis","year":"2021","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1874317\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:02:36Z","timestamp":1784811756000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1874317\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":15,"alternative-id":["10.3389\/fped.2026.1874317"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1874317","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"article-number":"1874317"}}