Influence of timing of maternal antibiotic administration during caesarean section on infant microbial colonisation: a randomised controlled trial

剖腹产 殖民地化 医学 随机对照试验 抗生素 儿科 怀孕 产科 内科学 生物 微生物学 殖民地化 遗传学
作者
Thomas H. Dierikx,Daniel J.C. Berkhout,Anat Eck,Sebastian Tims,Johan Van Limbergen,Douwe H. Visser,Marjon A. de Boer,Nanne K.H. de Boer,Daan J. Touw,Marc A. Benninga,Nine Schierbeek,Laura Visser,Jan Knol,Guus Roeselers,Johanna de Vries,Tim de Meij
出处
期刊:Gut [BMJ]
卷期号:71 (9): 1803-1811 被引量:27
标识
DOI:10.1136/gutjnl-2021-324767
摘要

Objective Revised guidelines for caesarean section (CS) advise maternal antibiotic administration prior to skin incision instead of after umbilical cord clamping, unintentionally exposing the infant to antibiotics antenatally. We aimed to investigate if timing of intrapartum antibiotics contributes to the impairment of microbiota colonisation in CS born infants. Design In this randomised controlled trial, women delivering via CS received antibiotics prior to skin incision (n=20) or after umbilical cord clamping (n=20). A third control group of vaginally delivering women (n=23) was included. Faecal microbiota was determined from all infants at 1, 7 and 28 days after birth and at 3 years by 16S rRNA gene sequencing and whole-metagenome shotgun sequencing. Results Compared with vaginally born infants, profound differences were found in microbial diversity and composition in both CS groups in the first month of life. A decreased abundance in species belonging to the genera Bacteroides and Bifidobacterium was found with a concurrent increase in members belonging to the phylum Proteobacteria. These differences could not be observed at 3 years of age. No statistically significant differences were observed in taxonomic and functional composition of the microbiome between both CS groups at any of the time points. Conclusion We confirmed that microbiome colonisation is strongly affected by CS delivery. Our findings suggest that maternal antibiotic administration prior to CS does not result in a second hit on the compromised microbiome. Future, larger studies should confirm that antenatal antibiotic exposure in CS born infants does not aggravate colonisation impairment and impact long-term health.

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