Caesarean birth, prolonged labour influence infant gut bacteria, risk of childhood obesity

October 02, 2020

Events at birth may affect the microbes living in a baby's gut during the first few months of life, leading to a higher risk of childhood obesity and allergies, according to a new study published in the journal Gastroenterology.

The researchers used data from the CHILD Cohort Study (CHILD) to look at the complex relationships between birth events, a baby's gut microbiome at three and 12 months of age, and health outcomes at ages one and three.

They linked factors such as caesarean section delivery and prolonged labour to changes in the gut microbes of infants. They then determined the pathways by which these alterations may lead to an increased risk of allergies and obesity later in childhood.

Senior author Anita Kozyrskyj, a CHILD investigator and professor in the Faculty of Medicine & Dentistry at the University of Alberta, said the findings highlight the importance of identifying multiple and common pathways of the gut microbiome during infancy.

"Much of what happens to us later in life is related to the exposures we encounter in infancy and early childhood," she said. "Understanding how disruptions to the gut microbiome affect health in later childhood means we may have several options for effective interventions to prevent these chronic conditions before they become established."

The study showed that infants born by caesarean section were more likely to have a high body-mass index score at ages one and three. When the researchers examined the children's microbiome profiles at three months of age, they found that an altered ratio of two types of bacteria--Enterobacteriaceae and Bacteroidaceae--was the dominant path to overweight.

At 12 months of age, a higher Enterobacteriaceae/Bacteroidaceae (E/B) ratio and colonization with Clostridioides difficile (C. difficile) were the main pathways leading to allergic sensitization.

"While caesarean birth was an initiating event for triggering over 100 gut microbial pathways leading to overweight and allergic sensitization, we found a higher E/B abundance ratio was the dominant compositional change," explained Kozyrskyj.

Infants born after prolonged labour associated with a first pregnancy were also found to be at higher risk for these health outcomes. The researchers found the E/B abundance ratio at three months was the most important microbiota mediator to overweight, and the E/B ratio at 12 months was the most important mediator to allergic sensitization. The abundance of Bifidobacterium, which was reduced with prolonged labour, also played a role in overweight development.

To conduct the study, Kozyrskyj's team collected stool samples from the diapers of 1,667 infants who are part of CHILD, a national birth cohort study following nearly 3,500 Canadian children from before birth to adolescence with the goal of discovering the root causes of allergies, asthma, obesity and other chronic diseases. They then analyzed the samples for gut microbes and their metabolites.

At one and three years of age, the children underwent skin prick tests to check for allergic sensitization to 10 common allergens.

The study's first author and former post-doctoral fellow, Khanh Vu, now an analyst in the U of A's Quality Management in Clinical Research unit, said he believes the central role of the infant gut microbiota involves the production of small molecules or metabolites. "Our study identified key interactions between Bifidobacterium and the metabolite, formate," he commented.

The research also highlighted the critical influence of C. difficile in all microbiota interactions, said Kozyrskyj.

"The takeaway from our study is that exposures at birth can trigger multiple and common gut microbial pathways leading to child overweight and allergic sensitization," she noted.

"We may want to take steps to avoid unnecessary caesarean section deliveries, and possibly consider postnatal microbiota solutions that may help to prevent these two conditions."
Funding partners for the CHILD Cohort Study include the Canadian Institutes of Health Research, the Allergy, Genes and Environment (AllerGen) Network of Centres of Excellence, and the Stollery Children's Hospital Foundation and supporters of the Lois Hole Hospital for Women through the Women and Children's Health Research Institute.

University of Alberta Faculty of Medicine & Dentistry

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal)

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to