Abstract
The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of newborns delivered by cesarean section compared to those vaginally delivered. Our objective was to evaluate the effect of ingestion of probiotics, prebiotics, or synbiotics during pregnancy and/or lactation on the development of the gut microbiota of the C-section newborns. We selected experimental studies in online databases from their inception to October 2021. Of the 83 records screened, 12 met the inclusion criteria. The probiotics used belonged to the genera Lactobacillus, Bifidobacterium, Propionibacterium, and Streptococcus, or a combination of those, with dosages varying between 2 × 106 and 9 × 1011 CFU per day, and were consumed during pregnancy and/or lactation. Probiotic strains were combined with galacto-oligosaccharides, fructo-oligosaccharides, or bovine milk-derived oligosaccharides in the synbiotic formulas. Probiotic, prebiotic, and synbiotic interventions led to beneficial gut microbiota in cesarean-delivered newborns, closer to that in vaginally delivered newborns, especially regarding Bifidobacterium colonization. This effect was more evident in breastfed infants. The studies indicate that this beneficial effect is achieved when the interventions begin soon after birth, especially the restoration of bifidobacterial population. Changes in the infant microbial ecosystem due to the interventions seem to continue after the end of the intervention in most of the studies. More interventional studies are needed to elucidate the optimal synbiotic combinations and the most effective strains and doses for achieving the optimal gut microbiota colonization of C-section newborns.
Highlights
The gut microbiota (GM) is the set of microorganisms coexisting in the gut of an individual [1]
In published analytical experimental studies, the effect of the probiotic, prebiotic, or synbiotic ingestion during pregnancy and/or lactation on the colonization of the GM of C-section newborns
Prebiotic, and synbiotic interventions led to a beneficial gut microbiota in C-section newborns, closer to that of vaginally delivered newborns, especially regarding Bifidobacterium colonization
Summary
The gut microbiota (GM) is the set of microorganisms coexisting in the gut of an individual [1] It plays an active role in the development and maturation of the gastrointestinal mucosal immune system (GALT) and in the defense against intestinal pathogens [1,2]. The newborn presents an immature immune system, which requires immunogenic stimuli from the developing GM for proper maturation [1,2]. Species from the genera Staphylococcus, Lactobacillus, and Bifidobacterium, have been identified in the meconium, placenta, and amniotic fluid of neonates of healthy pregnant women [3,4]. This early GM can be affected by external factors such as the route of birth and diet [2], and is essential for infant and adult health [5,6]
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