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Front. Microbiol. | doi: 10.3389/fmicb.2019.00598

The Perturbation of Infant Gut Microbiota Caused by Cesarean Delivery Is Partially Restored by Exclusive Breastfeeding

 Yu Liu1,  Shengtang Qin1, Yilin Song1,  Ye Feng1,  Na Lv2, Yong Xue2, Fei Liu2,  Shuxian Wang1,  Baoli Zhu2, 3, 4*,  Jingmei Ma1* and  Huixia Yang5*
  • 1Department of Obstetrics and Gynecology, Peking University First Hospital, China
  • 2Key Laboratory of Pathogenic Microbiology & Immunology, Institute of Microbiology (CAS), China
  • 3Beijing Key Laboratory of Antimicrobial Resistance and Pathogen Genomics, China
  • 4Department of Pathogenic Biology, School of Basic Medical Science, Southwest Medical University, China
  • 5Department of Obstetrics and Gynecology, Peking University First Hospital, Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, China

Early establishment of the infant gut microbiome has been attributed to various environmental factors that may influence long-term health. The aim of this study was to determine the single and combined impacts of the delivery mode, feeding pattern and postnatal antibiotic exposure on the initial establishment of infant gut microbiome at six weeks postpartum. A cross-sectional study was conducted at a single center in China. Fecal samples were collected from 120 infants at six weeks postpartum. The V3-V4 regions of 16S rRNA gene were analyzed by Illumina sequencing, and clinical information was obtained from medical records and questionnaire survey. Compared with vaginally delivered infants, the gut microbial community structure of cesarean delivered infants were significantly different (P = 0.044), in parallel with the decreased relative abundance of Bifidobacterium (P = 0.028), which contrasts with the normal gut microbial establishment. Using the vaginally delivered and exclusively breastfed (VB) infants as a reference, the comparative analysis of cesarean delivered and exclusively breastfed (CB) infants with cesarean delivered and mixed-fed (CM) infants showed that both within- and between-group UniFrac distance were significantly smaller in CB infants (P < 0.001, P < 0.001). LEfSe analysis showed that the relative abundances of Enterococcus, Veillonella and Faecalibacterium were significantly different between CB and CM infants, whereas the relative abundances of those genera in VB infants were close to those of CB infants, and distinct from those of CM infants. Additionally, no significant difference of microbial composition, alpha diversity, or community structure was observed between postnatal antibiotics exposed infants and unexposed infants. In summary, delivery mode had a significant impact on the infant gut microbial community structure and composition, and the gut microbiota was disturbed in infants delivered by cesarean section. However, our study showed that this disturbance of gut microbiota in cesarean delivered infants was partially restored by exclusive breastfeeding in comparison with mixed feeding. No distinct impact of postnatal antibiotic exposure on infant gut microbiome was found at six weeks of age.

Keywords: Infant, early life, gut microbiome, delivery mode, breastfeeding, Postnatal antibiotic exposure

Received: 26 Oct 2018; Accepted: 08 Mar 2019.

Edited by:

Steve Lindemann, Purdue University, United States

Reviewed by:

Maria Jose Gosalbes, Centre for Biomedical Network Research (CIBER), Spain
Amanda Veile, Purdue University, United States  

Copyright: © 2019 Liu, Qin, Song, Feng, Lv, Xue, Liu, Wang, Zhu, Ma and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Baoli Zhu, Key Laboratory of Pathogenic Microbiology & Immunology, Institute of Microbiology (CAS), Beijing, 100101, China, zhubaoli@im.ac.cn
Prof. Jingmei Ma, Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China, jingmeima@bjmu.edu.cn
Prof. Huixia Yang, Department of Obstetrics and Gynecology, Peking University First Hospital, Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China, yhxktz2018@163.com