Pregnant women with severe preeclampsia often require delivery by caesarean section under spinal (SA) or, less commonly, general anesthesia (GA), in order to improve maternal and perinatal outcomes. The advantages of SA for the mother are well substantiated now, whereas the impact on the fetus and the newborn is less certain. The purpose of the study — to evaluate characteristics of the period of early adaptation of newborns and perinatal outcomes of infants born by cesarean section to women with severe preeclampsia under general (GA) and spinal anesthesia (SA). Material and methods. The study included 65 newborn babies born by caesarean section to mothers with severe preeclampsia under the general (30) and spinal anesthesia (35). We analyzed the course of early postnatal adaptation of newborns and early neonatal period outcomes. We evaluated the morphometric parameters, the presence of fetal growth retardation syndrome (FGRS), Apgar score at the 1st and 5th minutes after birth, the degree of asphyxia, and the need for resuscitation. Gas homeostasis and the acid-base state of umbilical blood were examined. Results. When comparing the newborns of both groups by the gestation period, anthropometric data, the presence of FGRS, Apgar scores at 1 and 5 minutes, the severity of asphyxia at birth, no statistically significant differences between the groups were detected (p>0.05). The delivery was performed at 32—33 weeks of gestation, on average. 80% of the newborns in the GA group and 57.1% of SA group (p=0.05), OR=3.0 at 95% CI (0.981; 9.170) required respiratory support in the delivery room, mainly mask ventilation in the GA group (p=0.02). There were no significant differences in the parameters of the acid-base state in the arterial blood of the umbilical cord between GA and SA groups (p>0.05): pH (7.279±0.008 and 7.295±0.009, respectively); BEecf (–3.91±0.37 and –3.99±0.46 mmol/l) and lactate concentration (1.80±0.17 and 2.18±0.16 mmol/l). The lactate concentration in the venous blood was higher in SA group than in GA group (2.32±0.16 and 1.77±0.17 mmol/l; p=0.02). Newborns born to mothers with severe preeclampsia had a tense course of early neonatal adaptation processes and a high incidence of pathological conditions in the early neonatal period, without a statistically significant effect of the anesthetic method (p>0.05). The early neonatal period was complicated by hypoxic — ischemic CNS lesion in 97.1 and 100% of cases, hypoxic — hemorrhagic CNS lesion in 22.9 and 20%; and respiratory distress syndrome in 74.3 and 80%, in GA group and SA group, respectively. Conclusion. The method of anesthetic protection for abdominal delivery of pregnant women with severe preeclampsia does not have a statistically significant effect on the period of early neonatal adaptation and the development of major pathological conditions in newborns.