{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:56:59Z","timestamp":1772517419341,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cesarean deliveries (CD) have been associated with an increased risk for offspring long-term respiratory morbidity. We sought to evaluate whether children born via CD in different stages of labor, and partially exposed to vaginal flora, would differ in their long-term respiratory morbidity. Methods: A population-based study comparing long-term respiratory morbidity of children according to their mode of delivery and CD indication was conducted. Children born via CD for first stage non-progressive labor (CD-NPL1) and children born via CD for non-progressive labor in the second stage (CD-NPL2) were compared with children born vaginally (VD) as a reference group. Offspring hospitalizations up to 18 years involving respiratory morbidities were evaluated. Results: 313,782 deliveries were included; 97.7% were VD, 1.6% were CD for NPL1 and 0.7% were CD for NPL2. The overall respiratory-related hospitalization rates as well as the cumulative incidence of respiratory hospitalizations were significantly higher in children born via CD, with a graded association, related to fetal exposure to vaginal flora, noted between VD, CD-NPL2 and CD-NPL1 with the highest incidence. In a Cox model, controlling for multiple confounding variables, NPL1 (vs. VD) was associated with an increased risk for offspring long-term respiratory morbidity (aHR 1.15), while NPL2 did not differ in risk. Conclusions: The risk for respiratory morbidity is increased for NPL1 offspring (with lower exposure to vaginal flora) as compared with NPL2 and VD offspring, with a graded association noted between exposure to vaginal flora during labor and the risk for offspring long-term respiratory morbidity.<\/jats:p>","DOI":"10.3390\/jcm15051827","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:52:38Z","timestamp":1772207558000},"page":"1827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Offspring Long-Term Respiratory Morbidity Following Cesarean Delivery at Different Stages of Labor"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3824-9672","authenticated-orcid":false,"given":"Gil","family":"Gutvirtz","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1867-4727","authenticated-orcid":false,"given":"Hagar","family":"Brami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9057-4961","authenticated-orcid":false,"given":"Tamar","family":"Wainstock","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0454-6874","authenticated-orcid":false,"given":"Eyal","family":"Sheiner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Reznik, S.E., Akinyemi, A.J., Harary, D., Latuga, M.S., Fuloria, M., and Charron, M.J. 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