Cesarean Section and Chronic Immune Disorders

Sevelsted, Astrid; Stokholm, Jakob; Bønnelykke, Klaus; Bisgaard, Hans

doi:10.1542/peds.2014-0596

Cited by 422 publications

(302 citation statements)

References 39 publications

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“…For instance breast milk may contain viable microbes (albeit in small numbers) at the same time exerting potent prebiotic effect (McGuire et al, 2016). The interplay of altered gut microbiota composition and immune maturation should be further explored in the context of increased prevalence of chronic immune disorders seen in Caesarean section delivered infants (Sevelsted et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Sakwińska

Foata

Berger

et al. 2017

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The acquisition and early maturation of infant microbiota is not well understood despite its likely influence on later health. We investigated the contribution of the maternal microbiota to the microbiota of infant gut and nose in the context of mode of delivery and feeding. Using 16S rRNA sequencing and specific qPCR, we profiled microbiota of 42 mother-infant pairs from the GUSTO birth cohort, at body sites including maternal vagina, rectum and skin; and infant stool and nose. In our study, overlap between maternal vaginal microbiota and infant faecal microbiota was minimal, while the similarity between maternal rectal microbiota and infant microbiota was more pronounced. However, an infant's nasal and gut microbiota were no more similar to that of its own mother, than to that of unrelated mothers. These findings were independent of delivery mode. We conclude that the transfer of maternal vaginal microbes play a minor role in seeding infant stool microbiota. Transfer of maternal rectal microbiota could play a larger role in seeding infant stool microbiota, but approaches other than the generally used analyses of community similarity measures are likely to be needed to quantify bacterial transmission. We confirmed the clear difference between microbiota of infants born by Caesarean section compared to vaginally delivered infants and the impact of feeding mode on infant gut microbiota. Only vaginally delivered, fully breastfed infants had gut microbiota dominated by Bifidobacteria. Our data suggest that reduced transfer of maternal vaginal microbial is not the main mechanism underlying the differential infant microbiota composition associated with Caesarean delivery. The sources of a large proportion of infant microbiota could not be identified in maternal microbiota, and the sources of seeding of infant gut and nasal microbiota remain to be elucidated.

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Section: Discussionmentioning

confidence: 99%

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Sakwińska

Foata

Berger

et al. 2017

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“…However, more recent large cohort studies have found no association between the mode of delivery and the incidence of CD [55,56] . Vaccinations, due to modulation of immunity, have been proposed to be involved in the process of developing autoimmune diseases [57] .…”

Section: Other Environmental Factorsmentioning

confidence: 94%

Primary Prevention of Celiac Disease: Environmental Factors with a Focus on Early Nutrition

et al. 2015

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Celiac disease (CD) is a common autoimmune disorder caused by ingestion of gluten. When diagnosed, it should be treated with a lifelong, strict gluten-free diet. Early infant feeding practices have been suggested as a means of preventing CD. In the last few decades, observational data have suggested that breastfeeding, especially at the time of introducing gluten into the infant's diet, as well as the time and mode of gluten first being given to a child could prevent or delay the occurrence of CD. As a result, recommendations advised that it is prudent to avoid both early (<4 months) and late (>7 months) introduction of gluten, and to introduce gluten gradually while the infant is still being breastfed, as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Recently, the results of two large randomized trials have shown that breastfeeding in general, breastfeeding during gluten introduction, and early or delayed gluten introduction do not influence the total risk of CD in genetically predisposed individuals. Introducing gluten at 4 versus 6 months in very small amounts, or at 6 versus 12 months, resulted in similar rates of CD in these children. Thus, early feeding practices seem to have no impact on the risk of developing CD during childhood. In children without the genetic predisposition, the age and mode of gluten introduction do not influence the risk anyway.

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“…The gut microbiota is intimately associated with training the innate immune system, and its disruption in early life can result in infections, sepsis, and systemic immune and metabolic disorders, which influence lifelong disease risk [Zhu et al, 2015]. Microbial dysbiosis caused by Caesarean-section delivery has been associated with an increased risk of conditions such as asthma [Couzin-Frankel, 2010], obesity , food allergies [Lieberman et al, 2018], type 1 diabetes (T1D) [Kostic, 2015], systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease (IBD), and leukemia [Sevelsted et al, 2015] as shown Table 1. The purpose of this review is to present the current understanding of both the microbial risk factors that increase the likelihood of a Caesarean-section delivery and the microbial dysbiosis that is thought to result from it.…”

Section: Introductionmentioning

confidence: 99%

Dysbiosis in Children Born by Caesarean Section

Garcia¹,

Yee²,

Gilbert³

et al. 2018

Ann Nutr Metab

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The rate of Caesarean-section delivery in the United States has increased by 60% from 1996 through to 2013 and now accounts for > 30% of births [CDC, 2017]. The purpose of this review is to present the current understanding of both the microbial risk factors that increase the likelihood of a Caesarean-section delivery and the microbial dysbiosis that is thought to result from the Caesarean section. We provide examples of research into the impact of early-life microbial dysbiosis on infant development and long-term health outcomes, as well as consider the efficacy and the long-term implications of microbiome-based therapies to mitigate this dysbiosis. The steep rise in the Caesarean-section delivery rate makes it imperative to understand the potential of microbiota modulation for the treatment of dysbiosis.

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Cesarean Section and Chronic Immune Disorders

Cited by 422 publications

References 39 publications

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Primary Prevention of Celiac Disease: Environmental Factors with a Focus on Early Nutrition

Dysbiosis in Children Born by Caesarean Section

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