Mode of delivery and pondering potential sources of the neonatal microbiome

Aagaard, Kjersti M.

doi:10.1016/j.ebiom.2019.11.015

Cited by 12 publications

(6 citation statements)

References 10 publications

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“…Further research should be focused into understanding the cause of this low Bacteroides profile, particularly given up to 49% of VB microbiomes also have low Bacteroides [9] . Moreover, the possibility that CS-associated microbiomes are pre-set in utero due to prenatal microbial exposures warrants further investigation [6] .…”

Section: Discussionmentioning

confidence: 99%

“…Development of the gut microbiome during early life plays an influential role in facilitating immune development and milk digestion [ 1 , 2 ]. While the debate as to whether microbial colonisation begins in utero is ongoing [3] , [4] , [5] , [6] , the birthing process represents a critical period of microbial exposure. Neonates born by caesarean-section (CS) have consistently been found to harbour distinct gut microbiome profiles compared to vaginally-born (VB) neonates [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] .…”

Section: Introductionmentioning

confidence: 99%

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Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial

et al. 2021

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Background: Birth by caesarean section (CS) is associated with aberrant gut microbiome development and greater disease susceptibility later in life. We investigated whether oral administration of maternal vaginal microbiota to infants born by CS could restore their gut microbiome development in a pilot single-blinded, randomised placebo-controlled trial (Australian New Zealand Clinical Trials Registry, ACTRN12618000339257). Methods: Pregnant women scheduled for a CS underwent comprehensive antenatal pathogen screening. At birth, healthy neonates were randomised to receive a 3 ml solution of either maternal vaginal microbes (CSseeded, n = 12) or sterile water (CS-placebo, n = 13). Vaginally-born neonates were used as the reference control (VB, n = 22). Clinical assessments occurred within the first 2 h of birth, and at 1 month and 3 months of age. Infant stool samples and maternal vaginal extracts from CS women underwent shotgun metagenomic sequencing. The primary outcome was gut microbiome composition at 1 month of age. Secondary outcomes included maternal strain engraftment, functional potential of the gut microbiome, anthropometry, body composition, and adverse events. Findings: Despite the presence of viable microbial cells within transplant solutions, there were no observed differences in gut microbiome composition or functional potential between CS-seeded and CS-placebo infants at 1 month or 3 months of age. Both CS groups displayed the characteristic signature of low Bacteroides abundance, which contributed to a number of biosynthesis pathways being underrepresented when compared with VB microbiomes. Maternal vaginal strain engraftment was rare. Vaginal seeding had no observed effects on anthropometry or body composition. There were no serious adverse events associated with treatment. Interpretation: Our pilot findings question the value of vaginal seeding given that oral administration of maternal vaginal microbiota did not alter early gut microbiome development in CS-born infants. The limited colonisation of maternal vaginal strains suggest that other maternal sources, such as the perianal area, may play a larger role in seeding the neonatal gut microbiome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial

et al. 2021

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“…Many studies have now shown that prenatal and perinatal factors may impact microbiome composition, with inconsistent epidemiological associations with chronic disease risk [125]. It is believed that a lack of exposure to "immune-tolerizing" microbial products and toll-like receptor-2 (TLR-2) tolerizing bacterial products, may result in poorly regulated immune systems and increased immune-mediated diseases [126].…”

Section: Discussionmentioning

confidence: 99%

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

et al. 2021

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Background: Early life exposures impact immune system development and therefore the risk of immunemediated diseases, including inflammatory bowel disease (IBD). We systematically reviewed the impact of pre-, peri-, and postnatal exposures up to the age of five years on subsequent IBD diagnosis. Methods: We identified case-control and cohort studies reporting on the association between early life environmental factors and Crohn's disease (CD), ulcerative colitis (UC), or IBD overall. Databases were search from their inception until May 24th, 2019 until July 14th, 2020. We conducted meta-analyses for quantitative review of relevant risk factors that were comparable across studies and qualitative synthesis of the literature for a wide range of early life exposures, including maternal health and exposures during pregnancy, perinatal factors, birth month and related-factors, breastfeeding, hygiene-related factors and social factors, immigration, antibiotics, offspring health, including infections, and passive smoking. PROSPERO registration: CRD42019134980. Findings: Prenatal exposure to antibiotics (OR 1.8; 95% CI 1.2À2.5) and tobacco smoke (OR 1.5; 95% CI 1.2À1.9), and early life otitis media (OR 2.1; 95% CI 1.2À3.6) were associated with IBD. There was a trend towards an association between exposure to antibiotics in infancy and IBD (OR: 1.7, 95% CI 0.97, 2.9), supported by positive data on population-based data. Breastfeeding was protective against IBD. Other early life risk factors had no association with IBD, but data were limited and heterogenous. Interpretation: Early life is an important period of susceptibility for IBD development later in life. Tobacco smoke, infections and antibiotics were associated positively, and breastfeeding was associated negatively with IBD. Our findings offer an opportunity to develop primary prevention strategies. Funding: This study did not receive any funding.

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“…However, recent evidence suggests that the placenta, amniotic fluid, and membranes do in fact harbor a unique low biomass with low abundance microbiome. Hence, infant colonization may happen in utero rather than at delivery ( Aagaard, 2020 ;Liu et al, 2019 ;Yassour et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Colonization of the newborn respiratory tract and its association with respiratory morbidity in the first 6 months of life: A prospective cohort study

Nathan¹,

Chong²,

Teh³

et al. 2022

International Journal of Infectious Diseases

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Mode of delivery and pondering potential sources of the neonatal microbiome

Cited by 12 publications

References 10 publications

Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial

Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

Colonization of the newborn respiratory tract and its association with respiratory morbidity in the first 6 months of life: A prospective cohort study

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