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BackgroundThe rate of cesarean delivery was 35% in 2007 in Taiwan. It is unclear how many of the cesarean deliveries were without medical indications. Women's preference for cesarean delivery during their course of pregnancy has rarely been studied and therefore our objectives were to examine rate of cesarean deliveries without medical indications, to explore women's preference for cesarean delivery as their gestation advances, and to compare background and perinatal factors among women who underwent different modes of delivery in Taiwan.MethodsThis prospective study applied a longitudinal design. The study participants were 473 women who received prenatal care at four hospitals in Taipei and answered structured questionnaires at 20 to 24 weeks of pregnancy, 34 to 36 weeks of pregnancy, and 5 to 7 weeks after delivery.ResultsOf the 151 women (31.9%) who had cesarean deliveries, 19.9% were without medical indication. Three indications: malpresentation, prior cesarean section, and dysfunctional labor together accounted for 82.6% of cesarean section with medical indications. The prevalence of maternal preference for cesarean delivery was found to be 12.5% and 17.5% during the second and third trimester, respectively. Of the women who preferred cesarean delivery during the second trimester, 93.2% eventually had a cesarean delivery. Women who were older, with older spouses, and who had health problems before or during pregnancy were more likely to have cesarean deliveries.ConclusionsAbout 20% of cesarean deliveries were without medical indications. Women's preference for cesarean delivery during the second trimester predicts subsequent cesarean delivery. Counseling regarding mode of delivery should be offered early in pregnancy, especially for women who are older or with older spouses, have health problems, or had a prior cesarean section.

Virus factor is significantly related to human breast cancer, not only in terms of the oncogenetic process, but also in overall and relapse-free survivals.

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Although the answers to the etiology of nocturia are still not all known, nocturia has been associated with various factors, suggesting that multiple approaches are necessary in the treatment of patients with nocturia.

BackgroundHigh stress levels and shift work probably trigger migraine in healthcare professionals (HCPs). However, the migraine risk differences between HCPs and the general population is unknown.MethodsThis nationwide population-based cohort study used Taiwan’s National Health Insurance Research Database. Physicians (50,226), nurses (122,357), and other HCPs (pharmacists, technicians, dietitians, rehabilitation therapists, social workers, etc.) (45,736) were enrolled for the study cohort, and randomly selected non-HCPs (218,319) were enrolled for the comparison cohort. Conditional logistical regression analysis was used to compare the migraine risks. Comparisons between HCPs and between physician specialties were also done.ResultsPhysicians, nurses, and other HCPs had higher migraine risks than did the general population (adjusted odds ratio [AOR]: 1.672; 95 % confidence interval [CI]: 1.468–1.905, AOR: 1.621; 95 % CI: 1.532–1.714, and AOR: 1.254; 95 % CI: 1.124–1.399, respectively) after stroke, hypertension, epilepsy, anxiety, depression, and insomnia had been adjusted for. Nurses and physicians had higher migraine risks than did other HCPs (AOR: 1.303; 95 % CI: 1.206–1.408, and AOR: 1.193; 95 % CI: 1.069–1.332, respectively). Obstetricians and gynecologists had a lower migraine risk than did other physician specialists (AOR: 0.550; 95 % CI: 0.323–0.937).ConclusionHCPs in Taiwan had a higher migraine risk than did the general population. Heavy workloads, emotional stress, and rotating night shift sleep disturbances appear to be the most important risk factors. These findings should provide an important reference for promoting occupational health in HCPs in Taiwan.

This study examined the effect of the Baby-Friendly Hospital Initiative (BFHI) on the breastfeeding rate in Taiwan and analyzed factors related to BFHI qualification. The assessments included 56 hospitals enlisted for appraisal and 7,563 mothers in the maternity wards of these hospitals. Among the 56 hospitals appraised, 38 (67.9%) passed appraisal. Geographically, 88.5% (23/38) of hospitals are located in northern Taiwan, and only one hospital is situated in eastern Taiwan. All 13 medical centers enlisted for appraisal were qualified as BFHI. Only one private clinic passed the appraisal. We found close correlation between the location of the hospital and passing the appraisal (chi2 = 12.71, p < 0.01), and between the grade of a hospital and BFHI qualification (chi2 = 9.17, p < 0.05). Of the 10 steps to successful breastfeeding practiced in these hospitals, we found that step 10 got the highest scores, with a gain point rate of 94.64%; nonetheless, step 1 had significant power of discrimination regarding appraisal. Statistically, steps 7, 1, and 2 were more significant than any of the other steps. Mothers in qualified baby-friendly hospitals had higher breastfeeding rates than those in non-qualified hospitals, whether they were surveyed while in maternity wards after delivery (88.1% vs 78.1%) or in their first postnatal month (67.6% vs 59.4%). In conclusion, our study indicates that health policy intervention has a significant impact on increasing the breastfeeding rate in Taiwan.