title: Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study.
abstract: OBJECTIVE
  Dysbiosis of the infant gut microbiota may have long-term health consequences. This study aimed to determine the impact of maternal intrapartum antibiotic prophylaxis (IAP) on infant gut microbiota, and to explore whether breastfeeding modifies these effects.
  
  
  METHODS
  Prospective pregnancy cohort of Canadian infants born in 2010-2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Study.
  
  
  METHODS
  General community.
  
  
  METHODS
  Representative sub-sample of 198 healthy term infants from the CHILD Study.
  
  
  METHODS
  Maternal IAP exposures and birth method were documented from hospital records and breastfeeding was reported by mothers. Infant gut microbiota was characterised by Illumina 16S rRNA sequencing of faecal samples at 3 and 12 months.
  
  
  METHODS
  Infant gut microbiota profiles.
  
  
  RESULTS
  In this cohort, 21% of mothers received IAP for Group B Streptococcus prophylaxis or pre-labour rupture of membranes; another 23% received IAP for elective or emergency caesarean section (CS). Infant gut microbiota community structures at 3 months differed significantly with all IAP exposures, and differences persisted to 12 months for infants delivered by emergency CS. Taxon-specific composition also differed, with the genera Bacteroides and Parabacteroides under-represented, and Enterococcus and Clostridium over-represented at 3 months following maternal IAP. Microbiota differences were especially evident following IAP with emergency CS, with some changes (increased Clostridiales and decreased Bacteroidaceae) persisting to 12 months, particularly among non-breastfed infants.
  
  
  CONCLUSIONS
  Intrapartum antibiotics in caesarean and vaginal delivery are associated with infant gut microbiota dysbiosis, and breastfeeding modifies some of these effects. Further research is warranted to explore the health consequences of these associations.
  
  
  CONCLUSIONS
  Maternal #antibiotics during childbirth alter the infant gut #microbiome.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.|Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: M B
authors.initials: MB
authors.lastname: Azad
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Konya
authors.affiliation: College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: R R
authors.initials: RR
authors.lastname: Persaud
authors.affiliation: Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, ON, Canada.
authors.forename: D S
authors.initials: DS
authors.lastname: Guttman
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: Chari
authors.affiliation: Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada.
authors.forename: C J
authors.initials: CJ
authors.lastname: Field
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: M R
authors.initials: MR
authors.lastname: Sears
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: P J
authors.initials: PJ
authors.lastname: Mandhane
authors.affiliation: Department of Pediatrics, Child & Family Research Institute, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: S E
authors.initials: SE
authors.lastname: Turvey
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Subbarao
authors.affiliation: Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: A B
authors.initials: AB
authors.lastname: Becker
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Scott
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: A L
authors.initials: AL
authors.lastname: Kozyrskyj
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D001439:Bacteroides / Q000254:growth & development; D001942:Breast Feeding; D002585:Cesarean Section; D003013:Clostridium / Q000254:growth & development; D064806:Dysbiosis / Q000139:chemically induced*; D016983:Enterococcus / Q000254:growth & development; D005243:Feces / Q000382:microbiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy; D000069196:Gastrointestinal Microbiome / Q000187:drug effects*; D006801:Humans; D007223:Infant; D036801:Parturition; D011247:Pregnancy; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000517:prevention & control*; D013292:Streptococcus agalactiae
chemical_list: D000900:Anti-Bacterial Agents
keywords: Breastfeeding; caesarean section; gut microbiome; gut microbiota; infant; intrapartum antibiotics