Caesarean section, but not induction of labour, is associated with major changes in cord blood metabolome

Abstract

The physiology of how prelabour caesarean section (PCS) and induction of labour (IOL) in comparison to spontaneous vaginal delivery (SVD) has not been fully clarified yet. We measured 201 cord blood (CB) phospholipids and energy metabolites via LC/MS-MS in 109 newborns from the ROLO Kids study; metabolites were compared across the three parturition groups via linear mixed models with correction for multiple testing. In comparison to SVD, PCS babies had lower non-esterified fatty acids (NEFA), including sum of NEFA (p < 0.001), and trends for lower acylcarnitines. The lack of hormonal stimuli, especially catecholamines and cortisol, may underlie the metabolic changes involving gluconeogenesis from fatty acid oxidation (FAO) in PCS born infants. IOL and SVD infants showed no significant differences in metabolites, but ratios estimating carnitine palmitoyltrasferase 1 activity (precursor for FAO) were slightly higher in IOL than in SVD. Thus, IOL does not induce metabolic disadvantage when compared to SVD, though post-natal gluconeogenesis might start earlier due to the artificial solicitation in IOL. These data shed light on the physiology of parturition and may contribute to understand how mode of delivery might modulate future metabolic risks.

Neurodevelopment and Metabolism in the Maternal-Placental-Fetal Unit

“…We speculate that these unexpected findings are related to a metabolic switch that occurs during the perinatal transition . Labor is a highly coordinated process, associated with changes in maternal and fetal metabolism . Birth itself is associated with profound metabolic and transcriptomic changes in the newborn to maintain energy supply after losing the steady supply of maternal nutrients .…”

“… 30 Labor is a highly coordinated process, associated with changes in maternal and fetal metabolism. 31 , 32 Birth itself is associated with profound metabolic and transcriptomic changes in the newborn to maintain energy supply after losing the steady supply of maternal nutrients. 33 , 34 The placental and cord serum metabolomes were collected at the same postdelivery time point and likely reflect profound metabolic changes in this critical window, whereas maternal serum collected during the third trimester reflects a different developmental window.…”

Metabolomics: The Key to Unraveling the Role of the Microbiome in Visceral Pain Neurotransmission

“…The differences in delivery methods were later shown to have profound changes to the infant metabolome. For example, cesarean-delivered babies had substantially lower glucose, inulin, non-esterified fatty acids, and acylcarnitine levels when compared to vaginal-delivered babies ( Marchioro et al, 2019 ). Community differences within the intestinal microbiota is also observed between babies that were breast-fed and formula-fed, where breast-fed babies were found to have a greater abundance of species belonging to Lactobacillus and Bifidobacterium when compared to formula-fed infants ( Phan et al, 2019 ).…”

“…Studies have also demonstrated that the birth route, either vaginal or c-section, results in dramatic differences in the resident microbiota of the nasopharyngeal, skin, gut, and oral cavities ( Shao et al, 2019 ). Babies that were delivered by c-section were found to have a microbiota that was dominated by Staphylococcus and Streptococcus , whereas vaginal delivery resulted in an increased abundance of Lactobacillus species ( Marchioro et al, 2019 ). The differences in delivery methods were later shown to have profound changes to the infant metabolome.…”

Impact of perinatal factors on the maternal- neonatal microbiota and influence on health outcomes

“…Thus, the metabolic traits related to metabolic syndrome in an adult population may be beneficial during pregnancy and may also be involved in the labour process. Recently, Marchioro et al described how mothers who underwent a planned caesarean section showed lower levels of non-esterified fatty acids (NEFA) and acylcarnitines when compared with mothers who underwent a vaginal delivery with labour [476]. We hypothesised that the SCFA found in the amniotic cavity could be responsible for the observed association between the maternal microbiota at the time of delivery and the immune status of the amniotic fluid cavity.…”