From Birth to Overweight and Atopic Disease: Multiple and Common Pathways of the Infant Gut Microbiome Journal Articles uri icon

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  • BACKGROUND & AIMS: Few studies, even those with cohort designs, test the mediating effects of infant gut microbes and metabolites on the onset of disease. We undertook such a study. METHODS: Using structural equation modeling path analysis, we tested directional relationships between first pregnancy, birth mode, prolonged labor and breastfeeding; infant gut microbiota, metabolites, and IgA; and childhood body mass index and atopy in 1667 infants. RESULTS: After both cesarean birth and prolonged labor with a first pregnancy, a higher Enterobacteriaceae/Bacteroidaceae ratio at 3 months was the dominant path to overweight; higher Enterobacteriaceae/Bacteroidaceae ratios and Clostridioides difficile colonization at 12 months were the main pathway to atopic sensitization. Depletion of Bifidobacterium after prolonged labor was a secondary pathway to overweight. Influenced by C difficile colonization at 3 months, metabolites propionate and formate were secondary pathways to child outcomes, with a key finding that formate was at the intersection of several paths. CONCLUSIONS: Pathways from cesarean section and first pregnancy to child overweight and atopy share many common mediators of the infant gut microbiome, notably C difficile colonization.


  • Vu, Khanh
  • Lou, Wendy
  • Tun, Hein M
  • Konya, Theodore B
  • Morales-Lizcano, Nadia
  • Chari, Radha S
  • Field, Catherine J
  • Guttman, David S
  • Mandal, Rupasri
  • Wishart, David S
  • Azad, Meghan B
  • Becker, Allan B
  • Mandhane, Piush J
  • Moraes, Theo J
  • Lefebvre, Diana L
  • Sears, Malcolm R
  • Turvey, Stuart E
  • Subbarao, Padmaja
  • Scott, James A
  • Kozyrskyj, Anita L

publication date

  • January 2021

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