Caesarean section and gut microbiota in children
Abstract
Over the last two decades, the C-section rate has increased worldwide. It is understood that colonization patterns of intestinal microbiota in infant delivery in C-section vary from those that were delivered vaginally. These different microbial pattern and diversity will impact and respond to immune and dysbiosis-related diseases. This article examined the effect of C-section on gut microbiota in children.Recent Findings: Newborns are influenced by various factors, including mode of delivery, feeding, nutrition, hospitalization, antibiotic and host gene. Several studies have shown that infants with C-section have lower Bifidobacterium while others have shown lower abundance of Enterobactericeae and Bacteroides in infants with C-section compared to infants born vaginally. Although the mode of delivery is only one factor that influences infant microbiota composition, studies conclude that reduced microbial exposure during the C-section is important because it can affect dysbiosis several years after birth. Good microbiota is a key source of microbial-driven immune regulation, changes in normal patterns of bacterial colonization can alter the immune development outcome and may predispose to certain immune-related disorders later in life.Summary: The composition and concentrations of intestinal microbiota between vaginally and C-section born infants are significantly different. Among C-section infants, gut microbiota is associated with lower diversity and therefore induces dysbiosis, which can affect immune development and may predispose to some immune disorders, i.e. allergies in particular. Nutritional approach with pre-, probiotics, and/or synbiotics can have a promising effect early in life in preventing gut dysbiosis.Downloads
References
Wopereis H, Oozeer R, Knipping K, Belzer C, Knol J. The first thousand days–intestinal microbiology of early life: establishing a symbiosis. Pediat Allerg Imm-UK. 2014;25(5):428-38.
Rodríguez JM, Murphy K, Stanton C, Ross RP, Kober OI, Juge N, et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb Ecol Health Dis. 2015;26(1):26050.
Tamburini S, Shen N, Wu HC, Clemente JC. The microbiome in early life: implications for health outcomes. Nat Med. 2016;22(7):713.
Belkaid Y, Harrison OJ. Homeostatic immunity and the microbiota. Immunity. 2017;46(4):562-76.
Marques TM, Wall R, Ross RP, Fitzgerald GF, Ryan CA, Stanton C. Programming infant gut microbiota: influence of dietary and environmental factors. Curr Opin Biotech. 2010;21(2):149-56.
Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. PNAS. 2010;107(26):11971-5.
Bäckhed F, Roswall J, Peng Y, Feng Q, Jia H, Kovatcheva-Datchary P, et al. Dynamics and stabilization of the human gut microbiome during the first year of life. Cell Host Microbe. 2015;17(5):690-703.
Rutayisire E, Huang K, Liu Y, Tao F. The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants' life: a systematic review. BMC Gastroenterol. 2016;16(1):86.
Rescigno M, Urbano M, Valzasina B, Francolini M, Rotta G, Bonasio R, et al. Dendritic cells express tight junction proteins and penetrate gut epithelial monolayers to sample bacteria. Nat Immunol. 2001;2(4):361-7.
Fernández L, Langa S, Martín V, Maldonado A, Jiménez E, Martín R, et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacol Res. 2013;69(1):1-10.
Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med. 2014;6(237):237ra65-ra65.
Dominguez-Bello MG, De Jesus-Laboy KM, Shen N, Cox LM, Amir A, Gonzalez A, et al. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nat Med. 2016;22(3):250.
Cong X, Xu W, Romisher R, Poveda S, Forte S, Starkweather A, et al. Focus: Microbiome: Gut microbiome and infant health: Brain-gut-microbiota axis and host genetic factors. Yale J Biol Med. 2016;89(3):299.
Garcia MCS, Yee AL, Gilbert JA, Dsouza M. Dysbiosis in children born by caesarean section. Ann Nutr Metab. 2018;73(3):24-32.
Greenwood C, Morrow AL, Lagomarcino AJ, Altaye M, Taft DH, Yu Z, et al. Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter. Pediatrics. 2014;165(1):23-9.
Francavilla R, Cristofori F, Tripaldi ME, Indrio F. Intervention for dysbiosis in children born by C-section. Ann Nutr Metab. 2018;73(3):33-9.
Jakobsson HE, Abrahamsson TR, Jenmalm MC, Harris K, Quince C, Jernberg C, et al. Decreased gut microbiota diversity, delayed Bacteroidetes colonisation and reduced Th1 responses in infants delivered by caesarean section. Gut. 2014;63(4):559-66.
Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018;392(10155):1349-57.
Renz H, Brandtzaeg P, Hornef M. The impact of perinatal immune development on mucosal homeostasis and chronic inflammation. Nat Rev Immunol. 2012;12(1):9-23.
Ajslev T, Andersen C, Gamborg M, Sørensen T, Jess T. Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics. Int J Obesity. 2011;35(4):522-9.
Van Nimwegen FA, Penders J, Stobberingh EE, Postma DS, Koppelman GH, Kerkhof M, et al. Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy. J Allergy Clin Immunol. 2011;128(5):948-55. e3.
Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338-51.
Martin R, Nauta A, Ben Amor K, Knippels L, Knol J, Garssen J. Early life: gut microbiota and immune development in infancy. Benef Microbes. 2010;1(4):367-82.
Botteman MF, Munasir Z, Sulistomo AW, Horodniceanu EG, Bhanegaonkar AJ, Ji X, et al. Economic value of atopic dermatitis prevention via partially-hydrolyzed whey-based infant formula (PHF-W) use in high-risk, non-exclusively breastfed, Indonesian urban infants: results of a cost-effectiveness model. World Nut J. 2019;2(2):43-55.
Chua MC, Ben-Amor K, Lay C, Goh AE, Chiang WC, Rao R, et al. Effect of synbiotic on the gut microbiota of cesarean delivered infants: a randomized, double-blind, multicenter study. J Pediatr Gastr Nutr. 2017;65(1):102-6.
Abrahamsson TR, Wu RY, Jenmalm MC. Gut microbiota and allergy: the importance of the pregnancy period. Pediatr Res. 2015;77(1-2):214-9.
Fox A, Bird JA, Fiocchi A, Knol J, Meyer R, Salminen S, et al. The potential for pre-, pro-and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions. World Allergy Organ. 2019;12(5):100034.
Moya-Pérez A, Luczynski P, Renes IB, Wang S, Borre Y, Anthony Ryan C, et al. Intervention strategies for cesarean section–induced alterations in the microbiota-gut-brain axis. Nutr Rev. 2017;75(4):225-40.
Moossavi S, Miliku K, Sepehri S, Khafipour E and Azad MB. The Prebiotic and Probiotic Properties of Human Milk: Implications for Infant Immune Development and Pediatric Asthma. Front. Pediatr. 6:197
Heikkilä MP, Saris PE. Inhibition of Staphylococcus aureus by the commensal bacteria of human milk J. Appl Microbiol 2003; 95:471-478.
Boix-Amorós A, Collado MC, Mira A. Relationship Between Milk Microbiota, Bacterial Load, Macronutrients, and Human Cells During Lactation. Front Microbiol 2016;7:492.
Jost T, Lacroix C, Braegger C, Chassard C. Assessment of Bacterial Diversity in Breast Milk Using Culture-Dependent and Culture-Independent Approaches. Br J Nutr 2013 Oct;110(7):1253-62.
Plaza-Díaz J, Fontana L and Gil A. Human Milk Oligosaccharides and Immune System Development. Nutrients 2018; 10:1038.
Knol J, Scholtens P, Kafka C, Steenbakkers J, Gro S, Helm K, et al. Colon microflora in infants fed formula with galacto-and fructo-oligosaccharides: more like breast-fed infants. J Pediatr Gastr Nutr. 2005;40(1):36-42.
Moro, G., et al., A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Archives of Disease in Childhood, 2006. 91(10): p. 814-819.
Arslanoglu, S., et al., Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life. J Nutr, 2008. 138(6): p. 1091-5.
Arslanoglu, S., et al., Early neutral prebiotic oligosaccharide supplementation reduces the incidence of some allergic manifestations in the first 5 years of life. J Biol Regul Homeost Agents, 2012. 26(3 Suppl): p. 49-59.
Ismail IH, Boyle RJ, Licciardi PV, Oppedisano F, Lahtinen S, Robins‐Browne RM, et al. Early gut colonization by Bifidobacterium breve and B. catenulatum differentially modulates eczema risk in children at high risk of developing allergic disease. Pediat Allerg Imm-UK. 2016;27(8):838-46.
Li N, Yu Y, Chen X, Gao S, Zhang Q, Xu C. Bifidobacterium breve M‐16V alters the gut microbiota to alleviate OVA‐induced food allergy through IL‐33/ST2 signal pathway. J Cell Physiol. 2020.
Fiocchi A, Pawankar R, Cuello-Garcia C, Ahn K, Al-Hammadi S, Agarwal A, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics
Cuello-Garcia CA, Fiocchi A, Pawankar R,Yepes-Nuñez JJ, Morgano GP, Zhang Y, Ahn K, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Prebiotics
Hegar B, Wibowo Y, Basrowi RW, Ranuh RG, Sudarmo SM, Munasir Z, et al. The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition. Pediatr Gastroenterol Hepatol Nutr. 2019 Jul;22(4):330-340.
Submitted
World Nutrition Journal is an open acces journal and under the licence of
