From Birth to Overweight and Atopic Disease:...

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

Abstract

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.

Authors

Vu K; Lou W; Tun HM; Konya TB; Morales-Lizcano N; Chari RS; Field CJ; Guttman DS; Mandal R; Wishart DS

Journal

Gastroenterology, Vol. 160, No. 1, pp. 128–144.e10

Publisher

Elsevier

Publication Date

January 1, 2021

DOI

10.1053/j.gastro.2020.08.053

ISSN

0016-5085

Associated Experts

Padmaja Subbarao

Assistant Clinical Professor, FHSMED

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

Abstract

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Sustainable Development Goals (SDG)

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