This study aimed to clarify cesarean delivery effects on neonatal respiratory morbidity when women had preterm premature rupture of membranes. 

This retrospective study included women with preterm premature rupture of membranes delivered from 23 weeks to 33 weeks of gestation. Neonatal outcomes were compared between infants born by cesarean section and those delivered vaginally. The primary outcome was RDS. Neonatal intubation and mechanical ventilation periods were secondary outcomes. Propensity score matching was used to compare products between cesarean and vaginal delivery cases. 

There were 101 cesarean deliveries and 89 vaginal deliveries. Comparing the presence or absence of neonatal complications based on the delivery type indicated a higher RDS occurrence with cesarean deliveries. The intubation and mechanical ventilation periods were not significantly longer in neonates delivered via cesarean section. 

The study concluded that cesarean delivery is a risk factor for neonatal RDS in women with preterm premature rupture membranes. Trials identifying long-term neonatal prognoses are needed to further develop optimal management strategies in such cases. Further studies are required to explore the respiratory distress in the infants delivered through cesarean.