13 November 2020

Our recent study on Asthma in Childhood is published in Sci. Transl. Med.

Delivery mode and gut microbial changes correlate with an increased risk of childhood asthma

Jakob Stokholm, Jonathan Thorsen, Martin J. Blaser, Morten A. Rasmussen, Mathis Hjelmsø, Shiraz Shah, Emil D. Christensen, Bo L. Chawes, Klaus Bønnelykke, Susanne Brix, Martin S. Mortensen, Asker Brejnrod, Gisle Vestergaard, Urvish Trivedi, Søren J. Sørensen, Hans Bisgaard.

Science Translational Medicine 12, eaax9929 (2020).
To read the full article and see author affiliation follow the LINK

Introduction

The prevalence of delivery by cesarean section has increased globally in recent decades. The World Health Organization has suggested that cesarean section should be performed in less than 15% of births to prevent maternal and perinatal mortality and morbidity. However, most countries have a higher prevalence, suggesting less strict medical indications for performing the procedure. This suggests that cesarean section is a medical practice that has grown out of proportion to its need.

Delivery by cesarean section is associated with childhood asthma as well as a number of other immune-mediated diseases originating in childhood, including inflammatory bowel disease, juvenile arthritis, systemic connective tissue disorders, and immune deficiencies. These potential long-term side effects from the procedure are not considered in current cesarean section delivery recommendations.
The composition of the neonatal microbiota may be substantially affected by cesarean section delivery, as well as by the use of intrapartum antibiotics, which is the recommended practice during the procedure. The gut microbiota matures exten-sively within the early years of life, and cesarean section– induced gut microbial alterations may persist for a year or longer. Even if the composition eventually returns to the normal range akin to that of children born by vaginal delivery, a perturbed gut microbiota in this critical window may cause lifelong repercussions.

The gut microbiota has the ability to affect host immune maturation , and its perturbation during early life may increase the risk for later development of asthma, allergies, and other immune disorders.
Observational evidence suggests that cesarean section delivery modulates both the neonatal gut microbiota and childhood asthma risk, with gut microbial alterations implicated in mediating the in-creased risk of asthma in children born by cesarean section, but this has not yet been documented.

The objective of this study was to analyze the effects of delivery mode on the colonization patterns of the gut during the first year of life and to explore whether perturbations of the gut microbiota could explain the delivery mode–associated risk of developing asthma during childhood.

We used the well- established Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) mother-child cohort  to investigate these questions.

The result we found brings new hope for children born with ceserean section and you can read the full article and the results in the journal Science Translational Medicine 12, 2020.