Associations of birth mode with cord blood cytokines, white blood cells, and newborn intestinal bifidobacteria

Abstract

The associations of Cesarean delivery with offspring metabolic and immune-mediated diseases are believed to derive from lack of mother-to-newborn transmission of specific microbes at birth. Bifidobacterium spp., in particular, has been hypothesized to play a health-promoting role, yet little is known about how delivery mode modifies colonization of the newborn by this group of microbes. The aim of this research was to examine the presence of Bifidobacterium in meconium and in the transitional stool, and to assess cytokine levels and hematological parameters in the venous cord blood of infants born by elective, pre-labor Cesarean section vs. vaginal delivery in Southern Brazil. We recruited 89 mother-newborn pairs (23 vaginal delivery and 66 elective cesarean delivery), obtained demographic information from a structured questionnaire and clinical information from medical records. We obtained umbilical cord venous blood and meconium samples following delivery and the transitional stool (the first defecation after meconium) before discharge. We determined plasma levels of IL-1β, IL-10, IL-6, GM-CSF, IL-5, IFN-γ, TNF-α, IL-2, IL-4 and IL-8 in the cord blood, and presence of stool Bifidobacterium by real time PCR. Compared to vaginally-delivered neonates, Cesarean-delivered neonates had a lower leukocyte count (p = 0.037), lower hemoglobin (p = 0.04), and lower levels of the cytokine GM-CSF (p = 0.009) in the cord blood. Moreover, Bifidobacterium was detected less often in the transitional stool of Cesarean-delivered neonates compared to vaginally-delivered neonates (p = 0.001). The results indicate that pre-labor Cesarean birth may be associated with microbial and hematological alterations in the neonate. The clinical significance of these findings remains to be determined in larger prospective birth cohort studies.

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

“…Verbal aggression, intimidation, disrespectful behaviour and even sexual harassment can be seen as risk factors for emotional exhaustion and even burnout (Viotti et al, 2015). Lack of support for novice nurses in a demanding healthcare environment may lead to emotional distress (Chang, Chu, Liao, Chang, & Teng, 2018;Fleury, Grenier, Bamvita, & Farand, 2018) and job dissatisfaction (Adriaenssens, de Gucht, van der Doef, & Maes, 2011). Bacon (2017 showed that unexpected patient death as an existential event has a major impact on feelings of emotional distress, shock and failure in the nursing role.…”

Effect of dexmedetomidine combined with lumbar anesthesia on Th1/Th2 in maternal patients and neonates undergoing caesarean section

“…The present study demonstrated that dexmedetomidine combined with lumbar anesthesia resulted in decreased expression of IL-2 and TNF-α, and increased expression of IL-4 and IL-10 in maternal females after caesarean section and their neonates compared with those who had received lumbar anesthesia alone. Although caesarean section may influence the level of IL-2 and IL-4, no significant differences compared with pregnant women with normal delivery have been reported (32). In the present study, all participants received caesarean section; therefore, the changes of IL-2 and IL-4 are due to the different anesthetic treatments.…”

Microbiological and Immunological Markers in Milk and Infant Feces for Common Gastrointestinal Disorders: A Pilot Study

“…This finding might be related to the type of delivery. Most of the infants in CMPA group were born by Cesarean section, which has been related to lower Bifidobacterium content due, at least in part, to delayed initiation of breastfeeding [28]. Moreover, in this study fecal samples of CMPA infants were also characterized by a higher abundance of the genus Rothia and the families Lachnospiraceae, Peptostreptococcaceae and Eggerthellaceae.…”