Transient tachypnea of the newborn (TTN) is a common cause of early respiratory distress in the first 24–72 hours of life, especially in term and near-term infants delivered by elective cesarean section without labor. It is more frequent in repeat cesarean deliveries and may be associated with delayed clearance of fetal lung fluid, leading to impaired early respiratory adaptation. The literature shows that TTN occurs more often after cesarean delivery due to reduced physiological stress and hormonal changes that normally help remove lung fluid. This makes differentiation between TTN and early neonatal pneumonia clinically important. A reviewed clinical case of a term newborn with respiratory distress after elective cesarean section demonstrated persistent tachypnea beyond 48 hours, continued oxygen requirement, elevated C-reactive protein, and infiltrative changes on chest radiography. These findings supported a diagnosis of early neonatal pneumonia rather than isolated TTN. Overall, TTN in infants born to mothers with multiple uterine scars and repeated cesarean sections may indicate increased vulnerability in early respiratory adaptation. Careful monitoring and timely differential diagnosis between TTN and neonatal pneumonia are essential to ensure appropriate treatment and avoid delayed management of infectious causes.
