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. 2019 Mar;31(2):e23219.
doi: 10.1002/ajhb.23219. Epub 2019 Jan 28.

Pathways linking caesarean delivery to early health in a dual burden context: Immune development and the gut microbiome in infants and children from Galápagos, Ecuador

Amanda L Thompson  1   2   3 , Kelly M Houck  1 , Johanna R Jahnke  1   3
Affiliations

Pathways linking caesarean delivery to early health in a dual burden context: Immune development and the gut microbiome in infants and children from Galápagos, Ecuador

Amanda L Thompson et al. Am J Hum Biol. 2019 Mar.

Abstract

Objectives: Global increases in caesarean deliveries are exposing more infants to perinatal environments that are evolutionarily novel and potentially increasing their risks for inflammatory conditions. Yet, the pathways linking caesareans to later health outcomes are not well understood, particularly in dual burden contexts. We test two of the hypothesized pathways, altered immune function and gut microbiota, which may link delivery mode to later health outcomes and test whether these associations persist when controlling for postnatal nutritional and pathogenic exposures.

Methods: Data come from infants, aged 0 to 2 (n = 41), and young children, aged 2 to 11 (n = 135), from the Galápagos, Ecuador. Differences in morbidity, C-reactive protein (CRP), and gut microbiota by delivery type were tested using linear and logistic regression models adjusted for nutritional and pathogenic exposures and infant age.

Results: Over half of infants and over 40% of children were delivered by caesarean. Morbidity and CRP did not differ between infants or children born by caesarean or vaginally. Microbial taxa abundance differed by delivery mode. Infants born by caesarean had a higher abundance of Firmicutes and a lower relative abundance of Bacteroidales. Children born by caesarean had a higher abundance of Proteobacteria and Enterobacteriales. These differences remained after adjustment for environmental exposure.

Conclusions: Caesarean delivery is associated with differences in gut microbiota across childhood even in this dual burden context. Our results highlight the importance of examining caesarean delivery across diverse contexts to better understand the impact of perinatal interventions on short- and longer-term health outcomes.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1:
Figure 1:. Pathogenic and nutritional exposures by delivery mode in infants and children from Galápagos, Ecuador
*p<0.05 in bivariate testing (chi square for categorical and t-test for continuous variables)
Figure 2:
Figure 2:. Diversity in observed species by delivery mode in infants and children
Figure 3:
Figure 3:. Relative abundance of phyla and order by delivery mode in infants and children
See this image and copyright information in PMC

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