Pathways linking caesarean delivery to early health in a dual burden context: Immune development and the gut microbiome in infants and children from Galápagos, Ecuador

Thompson, Amanda L.; Houck, Kelly M.; Jahnke, Johanna R.

doi:10.1002/ajhb.23219

Cited by 14 publications

(11 citation statements)

References 65 publications

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“…This is the first study, to our knowledge, to apply these techniques using a sibling-adoption design to account for rearing environment and genetic relatedness. Our study is also one of few that looks beyond the first four years of life to assess associations between FP and MOD and gut microbial composition [47,50,51] Some limitations to consider are that the current study had diminishing power to detect statistically significant associations in a sample size of n = 73. Larger studies must be completed in order to confirm our results, although our sample size was sufficient to detect an effect size of 0.4 or larger.…”

Section: Strengths and Limitationsmentioning

confidence: 97%

History of breastfeeding but not mode of delivery shapes the gut microbiome in childhood

et al. 2020

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Background The naïve neonatal gut is sensitive to early life experiences. Events during this critical developmental window may have lifelong impacts on the gut microbiota. Two experiences that have been associated with variation in the gut microbiome in infancy are mode of delivery and feeding practices (eg, breastfeeding). It remains unclear whether these early experiences are responsible for microbial differences beyond toddlerhood. Aims Our study examined whether mode of delivery and infant feeding practices are associated with differences in the child and adolescent microbiome. Design, subjects, measures We used an adoption-sibling design to compare genetically related siblings who were reared together or apart. Gut microbiome samples were collected from 73 children (M = 11 years, SD = 3 years, range = 3-18 years). Parents reported on child breastfeeding history, age, sex, height, and weight. Mode of delivery was collected through medical records and phone interviews. Results Negative binomial mixed effects models were used to identify whether mode of delivery and feeding practices were related to differences in phylum and genus-level abundance of bacteria found in the gut of child participants. Covariates included age, sex, and body mass index. Genetic relatedness and rearing environment were accounted for as random effects. We observed a significant association between lack of breastfeeding during infancy and a greater number of the genus Bacteroides in stool in childhood and adolescence.

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Section: Strengths and Limitationsmentioning

confidence: 97%

History of breastfeeding but not mode of delivery shapes the gut microbiome in childhood

et al. 2020

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“…Prenatal stress (measured through a low CAR) may have decreased Bacteroidetes in the mother’s own microbiota, which the infant was exposed to in utero and during birth, while postpartum maternal stress may have shaped infant biology through physical environmental exposures, breastfeeding, or parenting behaviors. Other work in the Galápagos and elsewhere has found that Bacteroidaceae [ 88 ] and Bacteroides [ 84 ] are higher in infants born vaginally and those who are formula-fed. Low maternal CAR in the postpartum was also associated with a higher abundance of Veillonella , which has been associated with more cardiometabolic risk factors in adults [ 85 ].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is only the second study to assess the effects of maternal prenatal stress on infant gut microbiome development and associated HPA axis function in humans, and it is the first study to include both prenatal and postnatal stress in these models. Despite the fact that postnatal environments are known to contribute to infant gut composition [ 69 , 88 ], many studies on early gut development focus only on prenatal stress exposures. A few studies with animal models have tested the effects of infant postnatal stress on gut microbiome development [ 2 , 25 ], but to our knowledge, none of have tested this relationship in humans, which may be due to methodological limitations of examining stress in infants.…”

Section: Discussionmentioning

confidence: 99%

Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans

et al. 2021

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Background Early life exposure to adverse environments, and maternal stress in particular, has been shown to increase risk for metabolic diseases and neurobehavioral disorders. While many studies have examined the hypothalamic-pituitary-adrenal axis (HPA axis) as the primary mechanism behind these relationships, emerging research on the brain-gut axis suggests that the microbiome may play a role. In this study, we tested the relationships among maternal precarity and HPA axis dysregulation during the peripartum period, infant gut microbiome composition, and infant HPA axis functioning. Methods Data come from 25 mother-infant dyads in the Galápagos, Ecuador. Women completed surveys on precarity measures (food insecurity, low social support, depression, and stress) and gave salivary cortisol samples during and after pregnancy. Infant salivary cortisol and stool were collected in the postpartum. Statistical significance of differences in microbial diversity and relative abundance were assessed with respect to adjusted linear regression models. Results Maternal precarity was associated with lower diversity and higher relative abundance of Enterobacteriaceae and Streptococcaceae and a lower relative abundance of Bifidobacterium and Lachnospiraceae. These patterns of colonization for Enterobacteriaceae and Bifidobacterium mirrored those found in infants with HPA axis dysregulation. Maternal HPA axis dysregulation during pregnancy was also associated with a greater relative abundance of Veillonella. Conclusions Overall, exposures to precarity and HPA axis dysregulation were associated with an increase in groups that include potentially pathogenic bacteria, including Enterobacteriaceae, Streptococcaceae, and Veillonella, and a decrease in potentially protective bacteria, including Bifidobacterium and Lachnospiraceae, as well as a decrease in overall diversity.

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“…Pilot studies in Ecuador have demonstrated a relationship between CS and inflammatory diseases, which may predispose to future infections. 23,24 Therefore, it was appropriate to study the association between the delivery mode and allergic diseases in a nonindustrialized country in this setting by conducting a cross-sectional study of children aged 3-12 years living in Ecuador. The relationship between the current "allergy epidemic" and key environmental factors such as environmental pollution, lifestyle, nutrition, and bacterial contact in early childhood, has been investigated in the Latin American population, [12][13][14]25 but limited evidence exists on how the prevalence of allergic diseases is associated with the high rate of CS and the impact of socioeconomic background.…”

Section: Discussionmentioning

confidence: 99%

“…Ortiz‐Prado et al 22 investigated CS rates in Ecuador and found that the overall national CS rate in the private healthcare system was double that of the public healthcare system. Pilot studies in Ecuador have demonstrated a relationship between CS and inflammatory diseases, which may predispose to future infections 23,24 …”

Section: Discussionmentioning

confidence: 99%

Cesarean section and risk of allergies in Ecuadorian children: A cross‐sectional study

Gorris

Bustamante

Mayer

et al. 2020

Immunity Inflam & Disease

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Background Studies have shown an association between cesarean section (CS) and increased prevalence of childhood allergic diseases. While these observations have been consistent in industrialized countries, evidence from developing countries is limited. Objective To assess the association between the mode of delivery and allergic diseases in children aged 3–12 years in Quito, Ecuador. Methods In this cross‐sectional study, parents were surveyed using an anonymous, standardized questionnaire from the International Study of Asthma and Allergies in Childhood project to assess the presence of asthma, allergic rhinitis, atopic dermatitis, and food allergies in their children. The children's age, sex, birthplace, delivery mode (CS/vaginal), socioeconomic status, and ethnicity were recorded. Other parameters included gestational age, breastfeeding, smoking status during pregnancy, and parental allergic diseases. Results After adjusting for confounding factors, children delivered via CS were found to have a higher risk of wheezing (odds ratio [OR] = 4.12, 95% confidence interval [CI]: 1.43–11.89), physician‐diagnosed asthma (OR = 24.06; 95% CI: 1.98–292.3), and pimples, or eczema with the itching for 6 months (OR = 2.65; 95% CI: 1.06–6.61) than children delivered vaginally. No association was found between the delivery mode and rhinitis or food allergies. After stratifying by socioeconomic status, CS was only associated with allergic disorders in children of medium/high socioeconomic backgrounds. Conclusions As seen in industrialized settings, children born by CS in nonindustrialized countries have an increased risk of developing allergic disorders including asthma and dermatitis, compared to those delivered vaginally.

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Pathways linking caesarean delivery to early health in a dual burden context: Immune development and the gut microbiome in infants and children from Galápagos, Ecuador

Abstract: Pathways linking Caesarean delivery to early health in a dual burden context: immune development and the gut microbiome in infants and children from Galápagos, Ecuador

Cited by 14 publications

References 65 publications

History of breastfeeding but not mode of delivery shapes the gut microbiome in childhood

History of breastfeeding but not mode of delivery shapes the gut microbiome in childhood

Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans

Cesarean section and risk of allergies in Ecuadorian children: A cross‐sectional study

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