Impact of Intrapartum Antibiotic Prophylaxis on Offspring Microbiota.

S Prescott,R Koerner,A St Fleur,W A Henderson,G Trinchieri,C Dreisbach,M Canellas,A Gyamfi,K Baumgartel

doi:10.3389/fped.2021.754013

Abstract

Infants are born into a world filled with microbes and must adapt without undue immune response while exploiting the microbiota's ability to produce otherwise unavailable nutrients. The process by which humans and microbes establish this relationship has only recently begun to be studied with the aid of genomic methods. Nearly half of all pregnant women receive antibiotics during gestation to prevent maternal and neonatal infection. Though this has been largely successful in reducing early-onset sepsis, we have yet to understand the long-term consequences of antibiotic administration during gestation to developing infants. Studies involving antibiotic use in infants suggest that dysbiosis during this period is associated with increased obesity, allergy, autoimmunity, and chronic diseases in adulthood, however, research around the limited doses of intravenous antibiotics used for intrapartum prophylaxis is limited. In this mini review, we focused on the state of the science regarding the effects of intrapartum antibiotic prophylaxis on the newborn microbial colonization process. Although, the literature indicates that there is wide variety in the specific bacteria that colonize infants from birth, limited parenteral antibiotic administration prior to delivery consistently affects the microbiota of infants by decreasing bacteria in the phylum Bacteroidetes and increasing bacteria in the phylum Proteobacteria, thus altering the normal pattern of colonization that infants experience. Delivery by cesarean section and formula feeding magnify and prolong this effect. Our mini review shows that the impact of intravenous antibiotic administration during gestation has on early colonization, growth, or immune programming in the developing offspring has not been well studied in human or animal models.

Highlights

In order to better understand the impact of intrapartum antibiotic exposure on the microbiota of offspring, one must first consider the host-microbe environment
As Intrapartum antibiotic prophylaxis (IAP) is administered in vaginal deliveries for the prevention of GBS disease, most studies that examined the effect of IAP on the infant microbiota examine the covariance of both antibiotic exposure and GBS colonization
Neonatal mice exposed antibiotics during gestation produced inflammatory T cells that were unable to sustain normal interferon gamma production when stimulated [35]. These results indicate the microbiota derived products are required during early colonization and immune development to influence proper immune cell lineage programming and for intact signaling to elicit normal function

Summary

Introduction

In order to better understand the impact of intrapartum antibiotic exposure on the microbiota of offspring, one must first consider the host-microbe environment. While studying the direct effects of antimicrobial administration is important, establishing the impact of perinatal antibiotic prophylaxis, which is largely administered intravenously and of limited duration, will elucidate the effects on maternal and infant colonization, and the resultant impact on metabolic, immune, and neurobehavioral programing.

Results

Conclusion