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Ríos-Covian D, Langella P, Martín R. From Short- to Long-Term Effects of C-Section Delivery on Microbiome Establishment and Host Health. Microorganisms 2021; 9:microorganisms9102122. [PMID: 34683443 PMCID: PMC8537978 DOI: 10.3390/microorganisms9102122] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 12/02/2022] Open
Abstract
The establishment of gut microbiota has been proven to be impacted by several factors during pregnancy, delivery, and neonate periods. The body of evidence describing C-section delivery (CSD) as one of the most disruptive events during early life has expanded in recent years, concluding that CSD results in a drastic change in microbiota establishment patterns. When comparing the gut microbiota composition of CSD babies with vaginally delivered (VD) babies, the former show a microbiome that closely resembles that found in the environment and the mother’s skin, while VD babies show a microbiome more similar to the vaginal microbiome. Although these alterations of normal gut microbiota establishment tend to disappear during the first months of life, they still affect host health in the mid–long term since CSD has been correlated with a higher risk of early life infections and non-transmissible diseases, such as inflammatory diseases, allergies, and metabolic diseases. In recent years, this phenomenon has also been studied in other mammals, shedding light on the mechanisms involved in the effects of a CSD on host health. In addition, strategies to revert the disruptions in gut microbiomes caused by a CSD are currently in the process of development and evaluation. In this review, we discuss the recent advances in CSD research, from the alteration of gut microbiota establishment to the possible effects on host health during early life and development.
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Petrick L, Imani P, Perttula K, Yano Y, Whitehead T, Metayer C, Schiffman C, Dolios G, Dudoit S, Rappaport S. Untargeted metabolomics of newborn dried blood spots reveals sex-specific associations with pediatric acute myeloid leukemia. Leuk Res 2021; 106:106585. [PMID: 33971561 PMCID: PMC8275155 DOI: 10.1016/j.leukres.2021.106585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
The etiology of pediatric acute myeloid leukemia (AML) is largely unknown, but evidence for mutations in utero and long latency periods suggests that environmental factors play a role. Therefore, we used untargeted metabolomics of archived newborn dried blood spots (DBS) to investigate neonatal exposures as potential causal risk factors for AML. Untargeted metabolomics profiling was performed on DBS punches from 48 pediatric patients with AML and 46 healthy controls as part of the California Childhood Leukemia Study (CCLS). Because sex disparities are suggested by differences in AML incidence rates, metabolite features associated with AML were identified in analyses stratified by sex. There was no overlap between the 16 predictors of AML in females and 15 predictors in males, suggesting that neonatal metabolomic profiles of pediatric AML risk are sex-specific. In females, four predictors of AML were putatively annotated as ceramides, a class of metabolites that has been linked with cancer cell proliferation. In females, two metabolite predictors of AML were strongly correlated with breastfeeding duration, indicating a possible biological link between this putative protective risk factor and childhood leukemia. In males, a heterogeneous metabolite profile of AML predictors was observed. Replication with larger participant numbers is required to validate findings.
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Affiliation(s)
- Lauren Petrick
- The Institute of Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA.
| | - Partow Imani
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Kelsi Perttula
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA; Department of Health Sciences, California State University East Bay, Hayward, CA, 94542, USA
| | - Yukiko Yano
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Todd Whitehead
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Catherine Metayer
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Courtney Schiffman
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Georgia Dolios
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sandrine Dudoit
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA; Department of Statistics, University of California, Berkeley, CA, 94720, USA
| | - Stephen Rappaport
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA
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King J. Are there adverse outcomes for child health and development following caesarean section delivery? Can we justify using elective caesarean section to prevent obstetric pelvic floor damage? Int Urogynecol J 2021; 32:1963-1969. [PMID: 33877375 DOI: 10.1007/s00192-021-04781-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/24/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Elective pre-labour Caesarean section (CS) delivery is widely regarded as the panacea for all pelvic floor dysfunction despite substantial epidemiological evidence that it is only partially protective. To demand a CS is also considered a right for the well-counselled patient, even without an elevated risk of incontinence or prolapse. In recent years there has been increasing data on possible adverse health outcomes for children delivered by CS over those delivered vaginally. This includes respiratory illness, atopic conditions, obesity, diabetes and other severe auto-immune diseases. Concern has also been raised over possible impacts on cognitive and neuropsychological development in these children. Often the response has been to dismiss these outcomes as a result of the indication for the CS birth such as antenatal compromise or maternal disease. However the marked increase in non-medical Caesarean delivery throughout many regions of the world has allowed us to better distinguish these contributing factors. METHODS This narrative review looks at some of the more recent evidence on adverse health and developmental outcomes associated with CS, particularly pre-labour CS and the implications for the long term health of our society. RESULTS Epidemiological studies and animal research indicate an increased risk of negative impacts on child physical health and neuro-cognitive development aftercaesarean section delivery, particularly pre-labour Caesarean section, compared with vaginal delivery. This elevated risk persists after correction forobstetric and maternal factors. CONCLUSION Caesarean section delivery can result in adverse outcomes for infant, maternal and societal wellbeing. Elective Caesarean section, purely to potentially minimise pelvic floor dysfunction, cannot be justified.
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Affiliation(s)
- Jennifer King
- Pelvic Floor Unit, Westmead Hospital, Sydney, Australia.
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