Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study

BJOG: An International Journal of Obstetrics and Gynaecology - Tập 123 Số 6 - Trang 983-993 - 2016
Meghan B. Azad1,2, Theodore Konya3, RR Persaud4, David S. Guttman5, RS Chari6, Catherine J. Field7, M R Sears8, PJ Mandhane2, Stuart E. Turvey9, Padmaja Subbarao10, A.B. Becker1, Scott J. Tebbutt3, Anita L. Kozyrskyj2
1Department of Pediatrics & Child Health Children's Hospital Research Institute of Manitoba University of Manitoba Winnipeg MB Canada
2Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
3Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
4College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
5Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, ON, Canada
6Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
7Department of Agricultural, Food & Nutritional Science University of Alberta Edmonton AB Canada
8Department of Medicine, McMaster University, Hamilton, ON, Canada
9Department of Pediatrics Child & Family Research Institute BC Children's Hospital University of British Columbia Vancouver BC Canada
10Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

Tóm tắt

ObjectiveDysbiosis of the infant gut microbiota may have long‐term health consequences. This study aimed to determine the impact of maternal intrapartum antibiotic prophylaxis (IAP) on infant gut microbiota, and to explore whether breastfeeding modifies these effects.DesignProspective pregnancy cohort of Canadian infants born in 2010–2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Study.SettingGeneral community.SampleRepresentative sub‐sample of 198 healthy term infants from the CHILD Study.MethodsMaternal IAP exposures and birth method were documented from hospital records and breastfeeding was reported by mothers. Infant gut microbiota was characterised by Illumina 16S rRNA sequencing of faecal samples at 3 and 12 months.Main outcome measuresInfant gut microbiota profiles.ResultsIn this cohort, 21% of mothers received IAP for Group B Streptococcus prophylaxis or pre‐labour rupture of membranes; another 23% received IAP for elective or emergency caesarean section (CS). Infant gut microbiota community structures at 3 months differed significantly with all IAP exposures, and differences persisted to 12 months for infants delivered by emergency CS. Taxon‐specific composition also differed, with the genera Bacteroides and Parabacteroides under‐represented, and Enterococcus and Clostridium over‐represented at 3 months following maternal IAP. Microbiota differences were especially evident following IAP with emergency CS, with some changes (increased Clostridiales and decreased Bacteroidaceae) persisting to 12 months, particularly among non‐breastfed infants.ConclusionsIntrapartum antibiotics in caesarean and vaginal delivery are associated with infant gut microbiota dysbiosis, and breastfeeding modifies some of these effects. Further research is warranted to explore the health consequences of these associations.Tweetable abstractMaternal #antibiotics during childbirth alter the infant gut #microbiome.

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BJOG: An International Journal of Obstetrics and Gynaecology

Tập 123 Số 6

983-993

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