Dysbiosis in Children Born by Caesarean Section

Garcia, Mariana; Yee, Alyson L.; Gilbert, Jack A.; Dsouza, Melissa

doi:10.1159/000492168

Cited by 21 publications

(13 citation statements)

References 71 publications

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“…21,22 Moreover, HBV/HCV women had a higher rate of caesarean delivery, which was shown to alter fetal microbiome as compared to vaginal deliveries. 23,24 Thus, maternal microbiome changes in chronic HBV/HCV carriers contribute, at least in part, to the higher incidence of neurological diseases in offspring.…”

Section: Discussionmentioning

confidence: 99%

Maternal hepatitis B or C carrier status and long-term risk for offspring neurological morbidity: a population-based cohort study

Yoles

Sheiner

Abu‐Freha

et al. 2021

J Dev Orig Health Dis

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Hepatitis B and hepatitis C (HBV/HCV) are important global public health concerns. We aimed to evaluate the association between maternal HBV/HCV carrier status and long-term offspring neurological hospitalisations. A population-based cohort analysis compared the risk for long-term childhood neurological hospitalisations in offspring born to HBV/HCV carrier vs. non-carrier mothers in a large tertiary medical centre between 1991 and 2014. Childhood neurological diseases, such as cerebral palsy, movement disorders or developmental disorders, were pre-defined based on ICD-9 codes as recorded in hospital medical files. Offspring with congenital malformations and multiple gestations were excluded from the study. A Kaplan–Meier survival curve was constructed to compare cumulative neurological hospitalisations over time, and a Cox proportional hazards model was used to control for confounders. During the study period (1991–2014), 243,682 newborns met the inclusion criteria, and 777 (0.3%) newborns were born to HBV/HCV mothers. The median follow-up was 10.51 years (0–18 years). The offspring from HBV/HCV mothers had higher incidence of neurological hospitalisations (4.5 vs. 3.1%, hazard ratio (HR) = 1.91, 95% CI 1.37–2.67). Similarly, the cumulative incidence of neurological hospitalisations was higher in children born to HBV/HCV carrier mothers (Kaplan–Meier survival curve log-rank test p < 0.001). The increased risk remained significant in a Cox proportional hazards model, which adjusted for gestational age, mode of delivery and pregnancy complications (adjusted HR = 1.40, 1.01–1.95, p = 0.049). We conclude that maternal HBV or HCV carrier status is an independent risk factor for the long-term neurological hospitalisation of offspring regardless of gestational age and other adverse perinatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Maternal hepatitis B or C carrier status and long-term risk for offspring neurological morbidity: a population-based cohort study

Yoles

Sheiner

Abu‐Freha

et al. 2021

J Dev Orig Health Dis

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“…Large cohort studies have noted an association between caesarean section and autoimmune conditions and some of which are summarised in Table 1 of the open access paper ‘Dysbiosis in Children Born by Caesarean Section’ by Garcia et al in July 2018 [33]. Also there are at least 5 prospective studies [34, 35, 36, 37, 38] on the mode of delivery or use of intrapartum antibiotics and paediatric dysbiosis.…”

Section: Discussion About Recently Published Opinionsmentioning

confidence: 99%

The microbiome seeding debate – let’s frame it around women-centred care

Lokugamage

Pathberiya²

2019

Reprod Health

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In a global culture that is increasingly interested in ecological interventions, probiotics, ‘friendly bacteria’, microbiome preservation/restoration and long-term health, there is growing awareness of the idea of seeding the vaginal microbiome in the new born after caesarean section. It is postulated as a way of restoring helpful missing microbes and preventing long term non-communicable diseases of babies delivered by caesarean section. Currently, there is a deluge of evidence being published on the human microbiome, which can be challenging to digest and absorb by scientists, clinicians and patients. The specific evidence base around this technique is at its early stages. This commentary discusses what advice is currently available from a feminist and a person-centred care perspective. Abstrakt Det er en voksende interesse internasjonalt for økologiske intervensjoner, probiotika, ‘snille bakterier’, bevaring/gjenoppretting av. mikrobiomet og helse i et langtidsperspektiv. I denne sammenhengen er det en økende interesse for tanken om å så det vaginale mikrobiomet (vaginal seeding) på den nyfødte etter et keisersnitt. Dette er postulert som en måte å gjenopprette manglende normalflora/mikrobiom og forebygge langvarige ikke-smittsomme sykdommer hos barn født med keisersnitt. For tiden publiseres det mye forskning om menneskets mikrobiom, noe som kan være utfordrende å fordøye og ta til seg for forskere, klinikere og pasienter. Forskningen på denne spesifikke metoden er i sin begynnelse. Denne kommentaren drøfter hvilke råd som for øyeblikket er tilgjengelige, fra et feministisk og personsentrert omsorgsperspektiv. Popularisert sammendrag på norsk Det menneskelige mikrobiomet er summen av alle bakteriene som dekker den menneskelige kroppen og det hjelper kroppen i å fungere optimalt. Når mikrobiomet forstyrres, vil kroppen kunne få betennelsesreaksjoner og allergier. I fødsel finnes de «gode» bakteriene i kvinnens vagina. (det vaginale mikrobiomet) som man tror vil være fordelaktig for babyens evne til å utvikle et sunt immunsystem. Babyer som er født med keisersnitt vil ikke bli eksponert for disse «gode» bakteriene og det kan påvirke barnets immunforsvar negativt og potensielt øke sjansen for allergier og betennelsesreaksjoner i kroppen på lang sikt. Vaginal seeding (et forsøk på å gjenopprette balansen og noen av de gode bakterier i spedbarnet gjennom å tilføre mors vaginale bakterier via en kompress som strykes over spedbarnets ansikt) Vaginal seeding er en metode som noen forskere sier muligens delvis gjenoppretter de manglende «gode» bakteriene etter et keisersnitt. Forskningen er på et tidlig stadium. Det har vært avisartikler og en film om emnet og mødre har funnet ut om vaginal seeding som en måte å gjenopprette denne delen av babyens mikrobiom. Foreldre ønsker å diskutere vaginal seeding, men på nåværende tidspunkt er helsevesenet avventende og helsepersonell er ikke godt nok informert. Denne artikkelen vil se på den på...

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“…44 These extremely high Cesarian section rates are alarming because epidemiological studies show that children delivered by Cesarian section have higher risk for immunological disorders and diseases, such as asthma, allergic rhinitis, wheezing, allergic sensitization, food allergy, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel diseases, immune deficiencies, leukemia, obesity and type 1 diabetes, compared with children delivered vaginally. 45 Only a few studies have looked into the potential mechanisms behind these epidemiological findings. For instance, Cesarian section-delivered Finnish infants were shown to have a stronger nonspecific humoral immune response: they had higher total numbers of IgA-, IgG-, and IgMsecreting cells in blood than their vaginally delivered counterparts throughout the first year of life.…”

Section: (Figure With Permission From the Authors)mentioning

confidence: 99%

“…In 2015, Cesarian section was performed in 21.2% of live births globally, in 44.3% of all deliveries in Latin American and Caribbean regions, with Brazil hitting the top with a Cesarian section rate of 56% 44 . These extremely high Cesarian section rates are alarming because epidemiological studies show that children delivered by Cesarian section have higher risk for immunological disorders and diseases, such as asthma, allergic rhinitis, wheezing, allergic sensitization, food allergy, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel diseases, immune deficiencies, leukemia, obesity and type 1 diabetes, compared with children delivered vaginally 45 . Only a few studies have looked into the potential mechanisms behind these epidemiological findings.…”

Section: Perinatal Periodmentioning

confidence: 99%

Acquisition and establishment of the oral microbiota

Kaan

Kahharova

Zaura

2021

Periodontology 2000

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Acquisition and establishment of the oral microbiota occur in a dynamic process over various stages and involve close and continuous interactions with the host and its environment. In the present review, we discuss the stages of this process in chronological order. We start with the prenatal period and address the following questions: ‘Is the fetus exposed to maternal microbiota during pregnancy?’ and ‘If so, what is the potential role of this exposure?’ We comment on recent reports of finding bacterial DNA in placenta during pregnancies, and provide current views on the potential functions of prenatal microbial encounters. Next, we discuss the physiological adaptations that take place in the newborn during the birth process and the effect of this phase of life on the acquisition of the oral microbiota. Is it really just exposure to maternal vaginal microbes that results in the difference between vaginally and Cesarian section‐born infants? Then, we review the postnatal phase, in which we focus on transmission of microbes, the intraoral niche specificity, the effects of the host behavior and environment, as well as the role of genetic background of the host on shaping the oral microbial ecosystem. We discuss the changes in oral microbiota during the transition from deciduous to permanent dentition and during puberty. We also address the finite knowledge on colonization of the oral cavity by microbes other than the bacterial component. Finally, we identify the main outstanding questions that limit our understanding of the acquisition and establishment of a healthy microbiome at an individual level.

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Dysbiosis in Children Born by Caesarean Section

Cited by 21 publications

References 71 publications

Maternal hepatitis B or C carrier status and long-term risk for offspring neurological morbidity: a population-based cohort study

Maternal hepatitis B or C carrier status and long-term risk for offspring neurological morbidity: a population-based cohort study

The microbiome seeding debate – let’s frame it around women-centred care

Acquisition and establishment of the oral microbiota

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