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.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Vu K,Lou W,Tun HM,Konya TB,Morales-Lizcano N,Chari RS,Field CJ,Guttman DS,Mandal R,Wishart DS,Azad MB,Becker AB,Mandhane PJ,Moraes TJ,Lefebvre DL,Sears MR,Turvey SE,Subbarao P,Scott JA,Kozyrskyj ALdoi
10.1053/j.gastro.2020.08.053subject
Has Abstractpub_date
2021-01-01 00:00:00pages
128-144.e10issue
1eissn
0016-5085issn
1528-0012pii
S0016-5085(20)35149-0journal_volume
160pub_type
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