RESE 1174 Exploring Evidence for Professional Practice RESE 1174 Assignment Brief The student will be required to:
- Build on skills, knowledge and understanding gained in the previous modules, and demonstrate the ability to critically examine and evaluate an aspect of literature relevant to your chosen discipline.
- Demonstrate a thorough and systematic understanding of research processes and critiquing skills throughout the review, and present the findings in a critical, coherent, and structured manner.
- Develop and utilise information and communication technology to maintain an understanding of recent innovations and developments in care.
- Based on evidence outlined, evaluate professional practice in the context of patient-centered care to identify professional, legal and ethical implications.
RESE1174 Assignment Rubric Your project will be marked against the module Level 6 rubric
Research Title, Authors (et al. if more than 2 authors)
Date
&
Location
Aim of the Study
Research Methodology
Population and Sample Size Main Findings (approx. 100 words) Strengths and Weaknesses of research / methodology Implications for practice The influence of maternal gut and vaginal microbiota on gastrointestinal colonisation of neonates born vaginally and per caesarean section – Ronde et al – 2025 – Netherlands
To evaluate the role of maternal vaginal and rectal microbiota in early neonatal gut colonisation in vaginally born and caesarean born neonates Observational cohort study using maternal swabs and neonatal fecal samples with 16S rRNA sequencing 63 neonates in total – 23 vaginally born, 40 caesarean born Maternal microbial transfer contributed to neonatal gut colonisation, but shared ASV’s from maternal vaginal/rectal samples were generally low. There were no differences in shared ASVs from maternal vaginal swabs between the two delivery method groups, and only a day 7difference for maternal rectal swabs. This suggests delivery method matters, but maternal vaginal transfer alone may not fully explain early gut colonisation patterns. Strengths: recent study, direct comparison between vaginal birth and c-section births, molecular sequencing. Weaknesses: small sample, short follow up window
Supports careful interpretation of microbiome restoration strategies and suggests neonatal gut colonisation is more complex than simple vaginal exposure alone.
What is the influence of gut microbiome of babies born via vaginal and cesarean?
Themes: positive results / no difference
C-section vs vaginal birth
Discuss covid -2020 babies
Qualitative stuff on vaginal seeding
Comparison of gut microbiome between neonates born by cesarean section and vaginal delivery: Prospective observational study – Pahirah et al – 2024 – Thailand To investigate differences in gut microbiome of neonates delivered by c-section vs vaginal delivery and identifying predominant taxa in each group. Prospective observational study using fecal samples and 16S rRNA metagenomic sequencing 281 healthy neonates – 139 born vaginally and 141 born by c-section. Taxonomy could be identified in 89 vaginal born samples and 44 c-section born samples. Neonates born vaginally showed greater gut microbiome abundance and diversity than c-section delivered neonates. Bifidobacterium was dominant in both groups – Bifidobacterium breve was significantly higher in c-section neonates. The study supports delivery mode is important for early gut microbial composition. Strengths – large neonatal cohort, direct delivery mode comparison. Weaknesses – incomplete taxonomic identification across samples reduces usable microbiome data
Strengthens the argument that mode of delivery affects early microbial colonisation and may need to be considered in neonatal care. Cesarean delivery on maternal request and common child health outcomes: A prospective cohort study – Si et al – 2022 – China To investigate associations between non-medically indicated c-sections on maternal request and later child health outcomes Prospective cohort study 17,748 live-born infants were in the original trial cohort – for key analyses 6,972 born vaginally and 3,636 born by cesarean on maternal request. The study reported associations between cesarean deliveries on maternal request and adverse child outcomes including obesity, pneumonia, anemia, and some neurobehavioral outcomes. Because it compares non-medically indicated cesarean with vaginal births it helps reduce confounding from medical indications. Strengths – large cohort and stronger control of indication bias than other studies Weaknesses – Still observational
Useful for linking delivery mode to later health outcomes and supporting cautious use of elective c-sections without medical need. Role of cesarean section in the development of neonatal gut microbiota: A systematic review – Shaterian et al – 2021- Iran
References – not matrix
To investigate the role of cesarean section in the development of neonatal gut microbiota Systematic review reported using PRISMA 7 studies included The review found that colonisation of the neonatal gut microbiota in c-section born babies was generally lower than in vaginally delivered babies, especially in early life. Differences in colonisation patterns persisted across several time windows, supporting the idea that delivery mode is an important determinant of early microbial development. Strengths – synthesises evidence across multiple studies Weakness – only 7 studies were included, findings depends on quality and heterogeneity of those studies
Good evidence on delivery mode vs microbiome disruption Delayed establishment of gut microbiota in infants delivered by cesarean section – Kim et al – 2020 – South Korea To compare composition, structure and predicted metabolic function of microbiota in fecal samples from vaginally delivered and cesarean delivered infants Original research – longitudinal sampling over the first 2 weeks after birth 132 healthy Korean neonates – 64 vaginal delivery, 68 cesarean section The study found delayed establishment of early gut microbiota in cesarean born infants. Vaginally delivered infants had higher abundance of Bifidobacterium, Bacteroides, Lactobacillus and Lachnospiraceae, while cesarean born infants had more Enteroccaceae and Enterobacteriaceae and a more delayed ecological shift over time. Strengths – repeated early time point sampling, reasonably strong neonatal sample Weaknesses – no maternal microbiota samples, some maternal differences between groups
Strong support for c-section disrupts early gut colonisation Cesarean delivery is associated with decreased beneficial gut microbes and increased pathobionts and butyrate excretion: a longitudinal study over the first year of life – Mueller et al – 2021 – USA To prospectively examine associations between delivery mode and infant gut microbiota and fecal short-chain fatty acids at 3 and 12 months. Longitudinal cohort study 70 infants in analytic sample, 25 were delivered by c-section C-section delivery was associated with lower abundance of beneficial bacteria such as bifidobacterium and bateroides, higher abundance of potential pathobionts such as C.neonatale and C.perfringens, a higher fecal butyrate at 3 months. Some microbiome differences weer Strengths – Longitudinal design, functional metabolite data Weaknesses – Possible confounding from feeding methods, antibiotic exposure and socioeconomic factors
Useful for showing microbiome effects may extend beyond immediate newborn period Effects of vaginal microbiota transfer on the neurodevelopment and microbiome of cesarean born infants: a blinded randomised controlled trial – Zhou et al – 2023 – China To evaluate whether vaginal microbiota transfer improves microbiome development and neurodevelopmental outcomes in cesarean born infants Blinded randomised controlled trial ? find Accessible summaries report that vaginal microbiota transfer was likely safe and may partially normalise the fecal microbiome and neurodevelopment of cesarean born infants. Strengths – Clinically important outcomes, randomised controlled Weaknesses – intervention remains controversial
Important for discussing whether vaginal seeding/microbiota transfer is promising but still not routine practice Comparison of gut microbiome in neonates born by caesarean section and vaginal seeding with gut microbiomes of neonates born by caesarean section without vaginal seeding and neonates born by vaginal delivery – Anthoulaki et al – 2023 – Greece To compare microbiome patterns among c-section infants with vaginal seeding, c-section infants without vaginal seeding and vaginal delivered infants Prospective comparative study 290 neonates total – 110 c-sections with vaginal seeding, 85 c-sections without vaginal seeding and 95 vaginal deliveries Vaginal seeding in neonates born by c-section produces a gut microbiome more similar to vaginally delivered neonates, including bacteria such as Lactobacillus and Bacteroides. In contrast, c-section infants without seeding had a more limiting microbiome profile. Strengths – Three-group comparison, larger sample than other seeding studies Weaknesses – Single-centre design and ongoing uncertainty about safety and long term outcomes
Useful evidence that vaginal seeding may shift microbial profiles but it does not settle whether the practice should be routine. Effects of vaginal seeding on gut microbiota, body mass index, and allergy risk in infants born through cesarean delivery: a randomised clinical trial – Lui et al – 2023 – China To examine the effects of vaginal seeding on gut microbiota, growth and allergy risk in infants born via c-section. Randomised controlled trial 120 singleton term pregnant women scheduled for caesarean delivery were enrolled and randomised 1:1 – 117 infants were included in analyses Vaginal seeding had no significant effect on infant gut microbiota, BMI or allergy risk during the first 2 years of life. There were slight, non-significant increases in Lactobacillus and Bacteroides and a lower overweight/obesity risk at 6 months only but findings did not persist.
