The influence of timing of maternal antibiotic administration during C-section on infant microbial colonization

Title: The influence of timing of maternal antibiotic administration during C-section on infant microbial colonization

The first 1000 days of life lay the foundation for a child’s future health. During this critical period, the infant’s gut microbiome and immune system rapidly develop.

Multiple factors can impact the gut microbiome and immune system in early life, mode of delivery is one of them.
Vaginal birth is associated with the establishment of a healthy gut in the first days of life. Inherited from mums during birth, Bifidobacterium and Bacteroides species are early colonizers that play a key role in shaping a healthy gut milieu in infants in the first days of life.
Caesarean section (C-section) delivery may adversely affect the development of the infant gut microbiome by causing a delayed Bifidobacteria colonisation.
There is a growing body of evidence that indicates that a compromised microbiome in the first 100 days of life is a risk factor for early childhood infections and non-communicable diseases (NCD) later in life.

This NEW PUBLICATION ‘The influence of timing of maternal antibiotic administration during caesarean section on infant microbial colonization: a randomized controlled trial‘, published in ‘Gut’, investigates whether the timing of administrating antibiotics during c-section delivery contributes to the negatively impacted microbiota colonization.

In this randomized controlled trial women delivering their babies via c-section received antibiotics before the skin incision (n=20) or after umbilical cord clamping (n=20). A third group of women who delivered their babies vaginally (n=23) were included as control group.

The study concludes that c-section birth is associated with a delayed colonization by Bifidobacterium and Bacteroides species and early colonization by opportunistic pathogens (such as Proteobacteria) in the infant’s gut in the first month of life.
The infants born via c-section had profound differences in microbial diversity and composition in the first month of life compared to the infants born vaginally.
(These differences could not be observed at three years of age.)

Furthermore, the study demonstrates the strong effect that c-section has on early life microbiome development is independent maternal antibiotic exposure, as no differences were found between babies born from mothers that received antibiotics before the skin incision and those born by mothers with delayed antibiotics administration.

These results, associating c-section birth with a delayed colonization by Bifidobacterium species and early colonization by opportunistic pathogens, further strengthen the results that were found in this recent study: A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective Caesarean born infants | Danone Research & Innovation