Mode of Delivery and Early Neonatal Outcomes among Preterm Births in Three Hospitals in Western Libya: A Hospital-Based Observational Study

Abstract

Preterm birth remains a major cause of neonatal morbidity and mortality. The choice between vaginal delivery and cesarean section is influenced by gestational age, maternal health, fetal condition, placental complications, and available neonatal care. This study examined differences between vaginal/natural and cesarean delivery among preterm births in three hospitals in Western Libya, with respect to maternal age, diabetes status, gestational age, recorded indications, and early neonatal outcome. A hospital-based observational study was conducted on 45 women who delivered before 37 weeks of gestation at Msellata Central Hospital, Al-Khoms Almotaalem Hospital, and Souq Al-Khamees General Hospital between October 20 and November 29, 2024. Descriptive statistics (frequencies and percentages) were used. Of 45 preterm births, 21 (46.7%) were vaginal/natural, and 24 (53.3%) were cesarean. Diabetes was identified in three cases (6.7%). Women aged 26–<31 years predominated in the vaginal group; women aged 15–<23 and 23–<26 years predominated in the cesarean group. The modal gestational age was 31 weeks for vaginal births and 34 weeks for cesarean births. Placental abruption was the most common overall indication. Urinary tract infection was the most common indication for vaginal birth; cesarean births showed a wider range of indications. Four neonates (8.9%) died after birth, with two deaths in each delivery group. Cesarean delivery was slightly more frequent than vaginal delivery among the observed preterm births. Findings should be interpreted cautiously because delivery mode may not independently affect outcomes; rather, outcomes are likely related to underlying clinical indications and case complexity.