title: Perinatal microbial exposure may influence aortic intima-media thickness in early infancy.
abstract: The maternal and infant microbiome may influence infant cardiovascular risk through immune programming. The maternal vagino-enteric microbiome is often sampled for group B streptococcus (GBS) colonization during pregnancy. Our aim was to investigate the association between maternal GBS colonization, intrapartum antibiotics, antenatal pet exposure and infant aortic intima-media thickness (aIMT), an intermediate vascular phenotype, and whether this association varied by mode of delivery.
  
  
  
  The Barwon Infant Study is a population-derived pre-birth cohort. Perinatal data were collected on participants. Women were tested for vagino-enteric group B streptococcus (GBS) colonization during third trimester. Six-week infant aIMT was measured by trans-abdominal ultrasound. Adjustment for confounders included maternal age, pre-pregnancy body mass index (BMI), smoking, socioeconomic status, gestational diabetes, length of gestation, infant sex, birthweight and aortic internal diameter.
  
  
  
  Data were available on 835 mother-infant pairs. Of these, 574 (69%) women delivered vaginally; of those, 129 (22%) were GBS-colonized; and of these women, 111 (86%) received prophylactic intrapartum antibiotics. An association between maternal GBS colonization and infant aIMT was observed among those delivered vaginally (β = 19.5 µm, 95% CI 9.5, 29.4; P  < 0.0001) but not by Caesarean section ( P for interaction = 0.02). A similar pattern was seen for intrapartum antibiotics. There was a negative association between antenatal pet exposure and aIMT observed in those delivered vaginally.
  
  
  
  Maternal GBS colonization and intrapartum antibiotics were associated with increased infant aIMT in those delivered vaginally, whereas antenatal pet exposure was associated with decreased aIMT. These data suggest that differences in early life microbial experience may contribute to an increased cardiovascular risk.
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: McCloskey
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.|Department of Medicine, Deakin University, Waurn Ponds, VIC, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Vuillermin
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: John B
authors.initials: JB
authors.lastname: Carlin
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Cheung
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Skilton
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Mimi Lk
authors.initials: ML
authors.lastname: Tang
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Katie
authors.initials: K
authors.lastname: Allen
authors.affiliation: Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, WA, Australia.
authors.forename: Gwendolyn L
authors.initials: GL
authors.lastname: Gilbert
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Sarath
authors.initials: S
authors.lastname: Ranganathan
authors.affiliation: Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.|Department of Medicine, Deakin University, Waurn Ponds, VIC, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Collier
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Terence
authors.initials: T
authors.lastname: Dwyer
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Anne-Louise
authors.initials: AL
authors.lastname: Ponsonby
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.|Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Burgner
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001011:Aorta / Q000000981:diagnostic imaging*; D001315:Australia; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D057805:Pets; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D012307:Risk Factors; D013290:Streptococcal Infections / Q000188:drug therapy; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents
keywords: cardiovascular; infant; intima-media thickness; maternal; microbiome