Volume 123, Issue 6 p. 983-993
Intrapartum Care

Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study

MB Azad

MB Azad

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada

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T Konya

T Konya

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

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RR Persaud

RR Persaud

College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada

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DS Guttman

DS Guttman

Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, ON, Canada

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RS Chari

RS Chari

Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada

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CJ Field

CJ Field

Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada

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MR Sears

MR Sears

Department of Medicine, McMaster University, Hamilton, ON, Canada

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PJ Mandhane

PJ Mandhane

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

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SE Turvey

SE Turvey

Department of Pediatrics, Child & Family Research Institute, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada

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P Subbarao

P Subbarao

Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

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AB Becker

AB Becker

Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada

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JA Scott

JA Scott

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

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AL Kozyrskyj

Corresponding Author

AL Kozyrskyj

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

Correspondence: AL Kozyrskyj, PhD, Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy, 11405 – 87th Avenue, Edmonton, AB, Canada T6G IC9. Email [email protected]Search for more papers by this author
the CHILD Study Investigators

the CHILD Study Investigators

Canadian Healthy Infant Longitudinal Development Study investigators listed in Acknowledgements.Search for more papers by this author
First published: 28 September 2015
Citations: 409

Linked article: This article is commented on by BL Hughes, p. 994 in this issue. To view this mini commentary visit http://dx.doi.org/10.1111/14710528.13624.

Abstract

Objective

Dysbiosis of the infant gut microbiota may have long-term health consequences. This study aimed to determine the impact of maternal intrapartum antibiotic prophylaxis (IAP) on infant gut microbiota, and to explore whether breastfeeding modifies these effects.

Design

Prospective pregnancy cohort of Canadian infants born in 2010–2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Study.

Setting

General community.

Sample

Representative sub-sample of 198 healthy term infants from the CHILD Study.

Methods

Maternal IAP exposures and birth method were documented from hospital records and breastfeeding was reported by mothers. Infant gut microbiota was characterised by Illumina 16S rRNA sequencing of faecal samples at 3 and 12 months.

Main outcome measures

Infant gut microbiota profiles.

Results

In this cohort, 21% of mothers received IAP for Group B Streptococcus prophylaxis or pre-labour rupture of membranes; another 23% received IAP for elective or emergency caesarean section (CS). Infant gut microbiota community structures at 3 months differed significantly with all IAP exposures, and differences persisted to 12 months for infants delivered by emergency CS. Taxon-specific composition also differed, with the genera Bacteroides and Parabacteroides under-represented, and Enterococcus and Clostridium over-represented at 3 months following maternal IAP. Microbiota differences were especially evident following IAP with emergency CS, with some changes (increased Clostridiales and decreased Bacteroidaceae) persisting to 12 months, particularly among non-breastfed infants.

Conclusions

Intrapartum antibiotics in caesarean and vaginal delivery are associated with infant gut microbiota dysbiosis, and breastfeeding modifies some of these effects. Further research is warranted to explore the health consequences of these associations.

Tweetable abstract

Maternal #antibiotics during childbirth alter the infant gut #microbiome.