Abstract & Authors:展开
Background and aims: Few studies, even those with cohort designs, test the mediating effects of infant gut microbes and metabolites on the onset of disease. We undertook such a study.
Methods: Using SEM path analysis, we tested directional relationships between first pregnancy, birth mode, prolonged labour and breastfeeding; infant gut microbiota, metabolites and Immunoglobulin A; and childhood BMI and atopy in 1667 infants.
Results: Following both cesarean birth, and prolonged labour with a first pregnancy, a higher Enterobacteriaceae/Bacteroidaceae (E/B) ratio at 3 months was the dominant path to overweight; higher E/B ratios and Clostridiodes difficile colonization at 12 months were the main pathway to atopic sensitization. Depletion of Bifidobacterium following prolonged labour was a secondary pathway to overweight. Influenced by C. difficile colonization at 3 months, metabolites propionate and formate were secondary pathways to child outcomes, with a key finding that formate was at the intersection of several paths.
Conclusion: Pathways from cesarean section and first pregnancy to child overweight and atopy share many common mediators of the infant gut microbiome, notably C. difficile colonization.
Anita L Kozyrskyj
Khanh Vu,Wendy Lou,Hein M Tun,Theodore B Konya,Nadia Morales-Lizcano,Radha S Chari,Catherine J Field,David S Guttman,Rupasri Mandal,David S Wishart,Meghan B Azad,Allan B Becker,Piush J Mandhane,Theo J Moraes,Diana L Lefebvre,Malcolm R Sears,Stuart E Turvey,Padmaja Subbarao,James A Scott,Anita L Kozyrskyj