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Development of the Oral Microbiota01:28

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The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
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Related Experiment Video

Updated: May 18, 2026

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
14:56

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Published on: January 27, 2010

Pathways to a rising caesarean section rate: a population-based cohort study.

Christine L Roberts1, Charles S Algert, Jane B Ford

  • 1Department of Obstetrics, Gynaecology and Neonatology, University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia.

BMJ Open
|September 7, 2012
PubMed
Summary

Caesarean section rates increased significantly from 1994 to 2009, primarily driven by first births. Maternal factors and shifts in care settings explained only a small portion of this rise in caesarean delivery.

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Area of Science:

  • Obstetrics and Gynaecology
  • Public Health
  • Epidemiology

Background:

  • Caesarean section rates have been rising globally.
  • Understanding trends in obstetric pathways is crucial for maternal healthcare.
  • Previous studies have explored contributing factors, but decade-to-decade changes require further investigation.

Purpose of the Study:

  • To analyze changes in obstetric pathways leading to caesarean section over two decades.
  • To quantify the contribution of maternal and pregnancy factors to the increasing caesarean rate.
  • To assess the impact of shifts towards private hospital deliveries on caesarean section trends.

Main Methods:

  • A population-based record linkage cohort study was conducted in New South Wales, Australia.
  • Annual caesarean rates were examined for all births between 1994 and 2009.
  • Two cohorts of women having their first birth (1994-1997 vs. 2001-2004) were compared for changes in subsequent birth pathways.

Main Results:

  • First-birth caesarean section rates increased from 17.7% to 26.1% between the cohorts.
  • The rate of vaginal birth after caesarean (VBAC) decreased from 28% to 16% for second births.
  • Intrapartum caesarean rates for first births rose from 6.5% to 11.7% between 1994 and 2009.
  • Maternal/pregnancy factors and private hospital deliveries explained only 24% of the overall caesarean rate increase.

Conclusions:

  • The rise in caesarean sections for first births is the primary driver of the overall increase.
  • Maternal characteristics and changes in public versus private healthcare explain a limited proportion of the trend.
  • Shifting perceptions of risks associated with vaginal birth versus caesarean delivery may influence clinical and patient decisions regarding pregnancy management.