Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics

Abstract

Objective: To investigate whether delivery mode (vaginal versus by caesarean section), maternal pre-pregnancy body mass index (BMI) and early exposure to antibiotics (o6 months of age) influence child's risk of overweight at age 7 years, hence supporting the hypotheses that environmental factors influencing the establishment and diversity of the gut microbiota are associated with later risk of overweight. Design: Longitudinal, prospective study with measure of exposures in infancy and follow-up at age 7 years. Methods: A total of 28 354 mother-child dyads from the Danish National Birth Cohort, with information on maternal prepregnancy BMI, delivery mode and antibiotic administration in infancy, were assessed. Logistic regression analyses were performed with childhood height and weight at the 7-year follow-up as outcome measures. Results: Delivery mode was not significantly associated with childhood overweight (odds ratio (OR):1.18, 95% confidence interval (CI): 0.95-1.47). Antibiotics during the first 6 months of life led to increased risk of overweight among children of normal weight mothers (OR: 1.54, 95% CI: 1.09-2.17) and a decreased risk of overweight among children of overweight mothers (OR: 0.54, 95% CI: 0.30-0.98). The same tendency was observed among children of obese mothers (OR: 0.85, 95% CI: 0.41-1.76). Conclusion: The present cohort study revealed that a combination of early exposures, including delivery mode, maternal pre-pregnancy BMI and antibiotics in infancy, influences the risk of overweight in later childhood. This effect may potentially be explained by an impact on establishment and diversity of the microbiota.

MECHANISMS IN ENDOCRINOLOGY: Gut microbiota in patients with type 2 diabetes mellitus

“…Decreased insulin sensivity following 1 week of vancomycin treatment was observed in humans following changes in gut microbiota and bile acids (34), whereas a retrospective study has reported increased adiposity following antibiotic treatment with vancomycin for infectious endocarditis (58). In contrast to these observations, exposure to antibiotics in early life among children of overweight mothers has been associated with a decreased risk of overweight in childhood (52) and studies of ob/ob, high-fat diet-fed and insulin-resistant mice have demonstrated improved glucose tolerance following antibiotic treatment (22,59). Collectively, these studies may suggest that exposure to antibiotics early in life on one hand has the potential to disturb a healthy gut microbiota but, on the other hand, also has the potential to modify a disturbed microbiota towards a healthier state.…”

“…It has been speculated that the introduction of antibiotics in the early twentieth century may have contributed to the obesity epidemic and epidemiological studies have supported this notion as they have demonstrated that exposure to antibiotics in early childhood increases the risk of overweight in later childhood (52,53,54,55). Compared with children of normal-weight mothers not receiving antibiotics, the risk of overweight at age 7 years was increased by 1.5-fold among children receiving antibiotics during the first 6 months of life and born to normal-weight mothers (52).…”

“…Compared with children of normal-weight mothers not receiving antibiotics, the risk of overweight at age 7 years was increased by 1.5-fold among children receiving antibiotics during the first 6 months of life and born to normal-weight mothers (52). For comparison, the risk of overweight was increased by twofold among children not receiving antibiotics but born to overweight mothers (52). A later study reported a 1.2-fold increased risk of obesity at 38 months of age among children receiving antibiotics before 6 months of age (55).…”

Epigenetic mechanisms elicited by nutrition in early life

“…A longitudinal, prospective study in childhood revealed that a combination of early exposures, including delivery mode (vaginal v. by caesarean section), maternal pre-pregnancy BMI and antibiotics in infancy (less than 6 months of age), influences the risk of overweight in childhood, evaluated with a follow-up at age 7 years. This effect may potentially be explained by an impact on establishment and diversity of the microbiota (59) . Recently, Wang et al (60) identified a new direct link between gut flora-dependent metabolism of dietary phosphatidylcholine and CVD pathogenesis, which represents the leading cause of death and morbidity worldwide.…”

Excess weight and factors associated in preschool of southwest of Bahia

“…A similar bacterial profile have been found on intestinal microbiota in obese adults. 25 In this study, the exclusive breastfeeding less than four months was associated with EW. WHO recommends an exclusive breastfeeding until six months of years, since 2001.…”