C-Section Births Associated With Delay in Microbiota Development, Respiratory Infections

During the European Congress of Clinical Microbiology & Infectious Disease (ECCMID), being held in Amsterdam, the Netherlands, from April 13-16, researchers are presenting findings that suggests the mode of delivery influences the development of gut microbiota in infants, regardless of a mother’s use of antibiotics, which could then affect infants’ respiratory health during his or her first year.

There are more than 1000 different types of bacteria that live in the gut where they perform many vital functions to sustain life, such as digesting food, and stimulating the development of the immune system to protect the body against infection.

The prospective study enrolled 120 infants, of which 46 were delivered by caesarean section (C-section). Interestingly, the authors found that children born by C-section had a delay in what would be considered the “normal” development of their gut microbiota, and instead had a higher amount of potentially harmful bacteria compared with infants delivered vaginally.

The authors analyzed the gut microbiota of each infant using stool samples collected 10 times throughout their first year of life. Antibiotics were not administered to mothers undergoing a C-section until after clamping of the umbilical cord, and maternal stool samples were also analyzed 2 weeks postdelivery.

“Our findings suggest that the mode of delivery affects the developing infant gut microbiota, independent of a mother’s use of antibiotics during birth. Compared to vaginally delivered infants, children born by C-section have different trajectories of bacterial colonization, which could have implications for their future respiratory health,” Marta Reyman, a PhD candidate for pediatric immunology and an author on the study, said in a statement.

The analysis showed that the gut microbiota composition was significantly different between infants delivered vaginally and those delivered by C-section. Additionally, researchers observed measurable fecal seeding from mother to child in vaginally delivered infants, but not in children born by C-section.

Infants delivered by C-section demonstrated higher levels of potential pathogenic gut bacteria, regardless of length of hospital stay after birth, feeding type, and antibiotic use. Researchers also found that the gut microbiota in children born by C-section was less stable, and the development of Bifidobacterium spp., a health-promoting bacterial species, was delayed compared with vaginally delivered children.

Of note, the study authors found that gut microbiota early in life was associated with the total number of respiratory infections over the first year.

In terms of future research on the topic, Reyman suggested that researchers employ larger studies to fully understand the consequences of these changes, as the insights may help to design strategies to prevent health-related problems in children born by C-section.