The Influence of Cesarean Section on the Composition and Development of Gut Microbiota During the First 3 Months of Life

Abstract

The intestinal microbiota has emerged as a critical regulator of growth and development in the early postnatal period of life. Cesarean section (CS) delivery is one of the strongest disrupting factors of the normal colonization process and has been reported as a risk factor for disorders in later life. In this study, we dynamically and longitudinally evaluated the impact of CS on the initial colonization pattern and development of gut microbiota by 16 healthy Chinese infants with fecal samples collected at 9 time points (day 5, day 8, day 11, week 2, week 4, week 6, week 7, month 2, and month 3) during the first 3 months of life. The V3–V4 regions of 16S rRNA gene were analyzed by Illumina sequencing. In comparison with vaginally delivered (VD) infants, infants born by CS showed decreased relative abundance of Bacteroides and Parabacteroides and enrichment of Clostridium_sensu_stricto_1, Enterococcus, Klebsiella, Clostridioides, and Veillonella. Most interestingly, Firmicutes/Bacteroidetes ratio was found to be significantly higher in the CS group than in the VD group from day 5 until month 3. Besides, the results of microbial functions showed that the VD group harbored significantly higher levels of functional genes in vitamin B6 metabolism at day 5, day 8, week 2, week 4, week 6, week 7, month 2, and month 3 and taurine and hypotaurine metabolism at day 5, while the phosphotransferase system and starch and sucrose metabolism involved functional genes were plentiful in the CS group at day 11, week 2, week 4, week 6, week 7, and month 2 and at week 2, week 7, and month 2, respectively. Our results establish a new evidence that CS affected the composition and development of gut microbiota in the first 3 months and provide a novel insight into strategies for CS-related disorders in later life.

Neonatal Diet and Gut Microbiome Development After C-Section During the First Three Months After Birth: A Systematic Review

“…First, all studies presented data on the reduced relative abundance of Bacteroides . This concurs well with most of the studies presenting delayed colonization of Bacteroides as a fundamental characteristic of CS-delivered infants ( 10 , 44 , 45 ), indicating the essential role of attributes of cesarean delivery in the establishment of early gut microbiota. It is noted that Bacteroides and Parabacteroides are most frequently transmitted from the mother to neonates through vaginal birth ( 15 , 46 ).…”

“…In addition to that, Bacteroides depletion is associated with maternal IAP. The effect of IAP is supported by studies describing the administration of IAP in vaginal delivery, where a similar trend of Bacteroides reduction is reported (32,33,45,47). Both maternal transmission and IAP cause substantially lower colonization of Bacteroides from the first day after birth in CS infants.…”

Microbiome-based interventions to modulate gut ecology and the immune system

“…While the majority of FMT trials have focused on adults, its application during early life has also been explored. Children born via CSD have been identified to have a disturbed microbiome during early-life 79 . This altered microbiome has also been linked to reduced immune priming during the first days of life, which may result in the observed increase in occurrence of immune conditions in CSD children in later life 80 .…”

Reconstitution and Transmission of Gut Microbiomes and Their Genes between Generations

“…Cesarean section (CS) delivery is one of the strongest disrupting factors of the normal colonization process and has been reported as a risk factor for disorders in later life [125]. Human infants born by CS are colonized initially and primarily by skin microbiota [126,127].…”