From Short- to Long-Term Effects of C-Section Delivery on Microbiome Establishment and Host Health

David Ríos-Covian,Rebeca Martín,Philippe Langella

doi:10.3390/microorganisms9102122

Abstract

The establishment of gut microbiota has been proven to be impacted by several factors during pregnancy, delivery, and neonate periods. The body of evidence describing C-section delivery (CSD) as one of the most disruptive events during early life has expanded in recent years, concluding that CSD results in a drastic change in microbiota establishment patterns. When comparing the gut microbiota composition of CSD babies with vaginally delivered (VD) babies, the former show a microbiome that closely resembles that found in the environment and the mother’s skin, while VD babies show a microbiome more similar to the vaginal microbiome. Although these alterations of normal gut microbiota establishment tend to disappear during the first months of life, they still affect host health in the mid–long term since CSD has been correlated with a higher risk of early life infections and non-transmissible diseases, such as inflammatory diseases, allergies, and metabolic diseases. In recent years, this phenomenon has also been studied in other mammals, shedding light on the mechanisms involved in the effects of a CSD on host health. In addition, strategies to revert the disruptions in gut microbiomes caused by a CSD are currently in the process of development and evaluation. In this review, we discuss the recent advances in CSD research, from the alteration of gut microbiota establishment to the possible effects on host health during early life and development.

Highlights

Delivery by cesarean section (C-section, CS) is a life saver in certain risk-related situations, such as antepartum hemorrhages, fetal distress, abnormal fetal presentation, and hypertensive disease, the prevalence of maternal mortality and morbidity is higher after delivery by CS than after vaginal delivery (VD) [1]
The supplementation of 10% of XOS in C-section delivery (CSD) mice partially restored the composition of gut microbiota and was able to reduce the levels of iNK cells to those found in VD mice, but this did not increase the levels of T regulatory cells [51]
As vertical transmission seems to be the predominant form of obtaining gut microbiota, with the exception of some taxa and pathogenic bacteria [10,64], the understanding of this process during the infancy period could be essential to understanding some developmental phenomena that usually occur later in life

Summary

Introduction

Delivery by cesarean section (C-section, CS) is a life saver in certain risk-related situations, such as antepartum hemorrhages, fetal distress, abnormal fetal presentation, and hypertensive disease, the prevalence of maternal mortality and morbidity is higher after delivery by CS than after vaginal delivery (VD) [1]. Short-term effects have been reported, including an alteration to immune development; an increase in the risk of allergies, atopy, and asthma; and different microbiota colonization patterns. Several authors have observed the vertical transmission of bacterial strains from mother to infant, this transfer being specific to each mother–child pair [10] This vertical transmission could be altered by several neonatal factors that introduce abnormal microbiota in the newborn, a situation known as dysbiosis. CSD has been described as one of the major disruptions in microbiota colonization patterns [11], and these differences may be correlated with other health issues observed in later stages in human life. We will discuss the interventions and ongoing studies focusing on correcting the “disruptive” colonization that occurs after a CSD

Acquisition of the First Microbiota

Changes in Neonate Microbiota after C-Section Delivery

Literature

Strategies to Modulate the Aberrant Microbiota of CSD Babies

Findings

Conclusions