The Neonatal Microbiome and Its Partial Role in Mediating the Association between Birth by Cesarean Section and Adverse Pediatric Outcomes.
The Neonatal Microbiome and Its Partial Role in Mediating the Association between Birth by Cesarean Section and Adverse Pediatric Outcomes.
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作者：
Montoya-Williams D;Lemas DJ;Spiryda L;Patel K;Carney OO;Neu J;Carson TL
剖腹产（CS）是世界上最常见的外科手术之一。流行病学数据表明，剖宫产分娩与儿童某些不良健康结局（如哮喘和肥胖）的风险增加有关。探讨分娩方式对婴儿微生物组发育的影响，并讨论CS相关微生物生态失调在不良儿科健康结局发展中的潜在介导作用。并对今后的研究提出了建议。本研究提供了文献的叙述性概述，综合了从PubMed和其他计算机数据库和权威文本检索中检索到的文献结果。新出现的证据表明，分娩方式与新生儿微生物组的发展有关，并可能部分解释与CS分娩相关的儿科健康结果。具体而言，阴道分娩婴儿的肠道微生物组更接近于其母亲的阴道微生物组，因此更常见地由潜在有益的微生物群组成，如乳杆菌属、双歧杆菌属和拟杆菌属。相反，通过CS出生的婴儿的微生物组显示皮肤植物群或潜在致病性微生物群落（如克雷伯氏菌属、肠球菌属和梭菌属）的患病率增加。分娩方式在产后微生物组的发展中起着重要作用，但可能只是故事的一部分。有必要对所有可能影响新生儿微生物组的产前和围产期因素进行更全面的调查。
Cesarean sections (CS) are among the most commonly performed surgical procedures in the world. Epidemiologic data has associated delivery by CS with an increased risk of certain adverse health outcomes in children, such as asthma and obesity. To explore what is known about the effect of mode of delivery on the development of the infant microbiome and discuss the potentially mediating role of CS-related microbial dysbiosis in the development of adverse pediatric health outcomes. Recommendations for future inquiry are also provided. This study provides a narrative overview of the literature synthesizing the findings of literature retrieved from searches of PubMed and other computerized databases and authoritative texts. Emerging evidence suggests that mode of delivery is involved in the development of the neonatal microbiome and may partially explain pediatric health outcomes associated with birth by CS. Specifically, the gut microbiome of vaginally delivered infants more closely resembles their mothers’ vaginal microbiome and thus more commonly consists of potentially beneficial microbiota such as Lactobacillus, Bifidobacterium, and Bacteroides. Conversely, the microbiome of infants born via CS shows an increased prevalence of either skin flora or potentially pathogenic microbial communities such as Klebsiella, Enterococcus, and Clostridium. Mode of delivery plays an important role in the development of the postnatal microbiome but likely tells only part of the story. More comprehensive investigations into all the pre- and perinatal factors that have the potential to contribute to the neonatal microbiome are warranted.