Consequences of a cesarean section on the neonatal gut microbiome and future outcomes: a qualitative analysis of the literature

Abstract

Objective This study aims to evaluate the impact of cesarean section delivery on the neonatal intestinal microflora compared to vaginal deliveries. Design A mini-review. Methods A comprehensive search strategy was implemented, primarily using PubMed, to identify relevant studies published in English within the past 10 years. Selected studies were appraised by three independent reviewers using JBI critical appraisal and data extraction forms. Four articles were included in the analysis, encompassing systematic reviews and a retrospective cohort study. Primary and secondary outcome data were combined across these studies. Results Selected studies revealed consistent trends in bacterial colonization differences between cesarean and vaginal deliveries. Vaginally delivered infants exhibited higher populations of beneficial bacteria such as Bifidobacterium, Lactobacillus, and Bacteroides. Cesarean-delivered infants, on the other hand, showed greater colonization of Enterococcus, Klebsiella, Clostridium, Staphylococcus, Streptococcus, and Corynebacterium. Statistically significant differences were observed in two studies. All articles explored the potential health implications of these microbiome differences, with associations found between cesarean deliveries and various health outcomes. Conclusion This review demonstrates that cesarean section delivery influences the composition of the neonatal gut microbiota. The presence of certain bacterial species more prevalent in vaginally delivered infants, such as Bifidobacterium, is associated with improved infant health, while species found in cesarean-delivered infants, such as Clostridium, increase the risk of certain infections. Recognizing the increased health risks for cesarean-born infants enables clinicians to implement early screening, treatment, or prevention strategies, potentially reducing future morbidity and mortality.