Birth by caesarean section (CS) has been associated with altered gut microbiome development and an increased risk of certain diseases later in life. This has led to interest in interventions to restore the gut microbiome of CS-born infants to resemble that of vaginally-born (VB) infants. One such intervention, known as vaginal seeding, involves exposing CS-born infants to maternal vaginal microbiota. This previous research study aimed to investigate whether oral administration of maternal vaginal microbiota to infants born by CS could restore their gut microbiome development.
Methods
Study Design
This pilot single-blinded, randomised placebo-controlled trial involved pregnant women scheduled for a CS who underwent comprehensive antenatal pathogen screening. At birth, healthy neonates were randomised to receive either a 3 ml solution of maternal vaginal microbes (CS-seeded, n = 12) or sterile water (CS-placebo, n = 13). Vaginally-born neonates served as the reference control (VB, n = 22).
Key Findings
Gut Microbiome Composition
- No Significant Differences: There were no observed differences in gut microbiome composition or functional potential between the CS-seeded and CS-placebo infants at 1 month or 3 months of age.
- Characteristic Signature of CS Infants: Both CS groups displayed the characteristic signature of low Bacteroides abundance, leading to underrepresentation of several biosynthesis pathways compared with VB microbiomes.
- Maternal Strain Engraftment: Maternal vaginal strain engraftment was rare, suggesting limited colonization of maternal vaginal strains in the CS-seeded group.
- No Effect on Growth: Vaginal seeding had no observed effects on anthropometry or body composition within the first 3 months of life.
- Safety: No serious adverse events were associated with the treatment. Maternal pathogen screening successfully minimized infection risk.
Secondary Observations
- The limited colonization of maternal vaginal strains implies that other maternal sources, such as the perianal area, may play a more significant role in seeding the neonatal gut microbiome.
- This study corroborated previous findings that CS-born infants have lower relative abundances of Bacteroides spp. compared to VB infants.
- The findings suggest that oral administration of maternally-derived faecal microbiota (FMT) might be more effective in restoring gut microbiome composition in CS-born infants.
The oral administration of maternal vaginal microbiota did not alter the structure or function of the early gut microbiome in CS-born infants. This pilot study suggests that vaginal seeding, as performed, does not provide significant benefits in restoring gut microbiome development in CS-born infants.
Link to the article : https://tinyurl.com/mujwz4uu
