The goal of this observational study is to examine national trends in mode of delivery and to assess associations between cesarean section and early-life health outcomes using routinely collected health data in Thailand. The study includes mother-infant dyads delivering in public hospitals across Thailand.

The main questions it aims to answer are:

Is cesarean delivery associated with increased risk of adverse neonatal outcomes compared with vaginal delivery?

Is cesarean delivery associated with differences in early-life healthcare utilization and breastfeeding outcomes during the first year of life?

Researchers will compare infants born by cesarean section with infants born by vaginal delivery to evaluate differences in neonatal morbidity, healthcare utilization, and breastfeeding patterns.

Participants will not receive any intervention. The study involves secondary analysis of de-identified national health administrative and clinical data, including delivery records and linked maternal and infant health outcomes.

Inclusion Criteria:

• Mother-infant dyads with delivery records available in the national health administrative database.
• Deliveries occurring in public hospitals in Thailand during the study period.
• Records containing information on mode of delivery and linked maternal and infant outcomes.

Exclusion Criteria:

• Records with missing or invalid delivery mode information.
• Records that cannot be reliably linked between mother and infant.

This study includes mother-infant dyads identified retrospectively from routinely collected, de-identified national health administrative and clinical data from public hospitals in Thailand.