MODE OF DELIVERY DOCHEAD-EFFECTS ON GUT MICROBIOTA AND HUMORAL IMMUNITY

Aim:

To evaluate the establishment of gut microbiota in children born by vaginal versus caesarean delivery and its impact on mucosal immunity.

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Methods:

165 consecutive children were followed from birth, 141 (85%) born by vaginal delivery and 24 (15%) by caesarean section. Infants exposed to probiotics directly or through the mother were excluded. Enzyme-linked immunospot (ELISPOT) assay was used for indirect evaluation of mucosal immunity and fluorescence in situ hybridization of bacterial cells (FISH) for determination of the gut microbiota.

Results:

At 1 month of age, the total gut bacterial cell counts were higher in vaginally delivered infants (9.9E9, 95% CI 7.9E9-1.2E10) as compared to caesarean delivered (3.1E9, 1.1E9-8.6E9) (p = 0.001). This distinction was due to the greater number of bifidobacteria in vaginally delivered infants (1.9E9, 95% CI 6.3E8-5.6E9 versus 1.5E6, 95% CI 4.1E2-5.7E9), (p = 0.001), but not the numbers of Clostridia, Lactobacilli or Bacteroides. During the first year of life, the number of total IgA-secreting cells was lower (p = 0.03) in infants born by vaginal versus caesarean delivery, possibly reflecting excessive antigen exposure across the vulnerable gut barrier resulting from inadequate development of the gut microbiota.

Summary:

A significant correlation between the mode of delivery, gut microbiota and mucosal immunity was detected.

Conclusion:

The mode of delivery has, via gut microbiota development, significant effects on immunological defence in the infant.