Vacuum-Assisted Delivery and Neonatal Intensive Care Unit Admission: A Retrospective Case-Control Study at a Lebanese Hospital.

BACKGROUND: Vacuum-assisted vaginal delivery (VAVD) is a common obstetric intervention used to facilitate childbirth. In Lebanon, the practice remains inconsistently applied. Standardized national guidelines and their impact on neonatal outcomes, particularly neonatal intensive care unit (NICU) admissions, remain insufficiently explored. OBJECTIVE: To examine the association between VAVD and NICU admission in a tertiary hospital in Lebanon. METHODS: A retrospective hospital-based case-control study was conducted between January 2021 and December 2023. Cases were defined as neonates admitted to the NICU after delivery, and controls as neonates not requiring NICU admission. Prior exposure (mode of delivery: VAVD vs. spontaneous vaginal delivery) and maternal, obstetric, and neonatal variables were compared between the two groups. All live-born neonates (n = 488), including both term and preterm infants, were screened. Data were extracted from medical records, and multivariate logistic regression was used to assess the association between VAVD and NICU admission. RESULTS: VAVD was not significantly associated with NICU admission (adjusted OR = 2.11; 95% CI: 1.00-4.49; p = 0.051). CONCLUSION: In this setting, VAVD was not associated with an increased likelihood of NICU admission. Strengthening guidelines and training for VAVD use may help optimize neonatal outcomes in Lebanon.