Pediatrics. Consilium MedicumPediatrics. Consilium MedicumПедиатрия. Consilium Medicum2658-66302658-6622Consilium Medicum63332010.26442/26586630.2024.1.202613ArticlesСтатьиReview ArticleWhy does it matter to the pediatrician whether the baby was born naturally or by Cesarean section? A reviewПочему педиатра интересует вопрос, родился ли ребенок естественным путем или с помощью операции кесарева сечения?https://orcid.org/0000-0003-4200-4598ZakharovaIrina N.ЗахароваИрина Николаевна
Russian Federation

Sci. (Med.), Prof.

доктор медицинских наук, проф., засл. врач России, зав. каф. педиатрии им. акад. Г.Н. Сперанского

zakharova-rmapo@yandex.ruhttps://orcid.org/0009-0005-2121-4010OrobinskayaYana V.ОробинскаяЯна Владимировна
Russian Federation

Graduate Student

аспирант каф. педиатрии им. акад. Г.Н. Сперанского

zakharova-rmapo@yandex.ruhttps://orcid.org/0000-0002-2847-6268BerezhnayaIrina V.БережнаяИрина Владимировна
Russian Federation

Cand. Sci. (Med.)

кандидат медицинских наук, доц. каф. педиатрии им. акад. Г.Н. Сперанского, врач-педиатр, гастроэнтеролог

berezhnaya-irina26@yandex.ruhttps://orcid.org/0000-0002-2861-5619SugianNarine G.СугянНарине Григорьевна
Russian Federation

Cand. Sci. (Med.)

кандидат медицинских наук, доц. каф. педиатрии им. акад. Г.Н. Сперанского

narine6969@mail.ruhttps://orcid.org/0000-0002-3335-7124DedikovaOlga V.ДедиковаОльга Валерьевна
Russian Federation

pediatrician, Department Applicant

врач-педиатр, соискатель каф. педиатрии им. акад. Г.Н. Сперанского

olga.dedikova74@yandex.ruhttps://orcid.org/0000-0003-2521-0824MalyavskayaSvetlana I.МалявскаяСветлана Ивановна
Russian Federation

Sci. (Med.), Prof.

доктор медицинских наук, проф., зав. каф. педиатрии

zakharova-rmapo@yandex.ruhttps://orcid.org/0009-0002-2973-1256KurbakovaDaria M.КурбаковаДарья Михайловна
Russian Federation

Student

студентка VI курса педиатрического факультета

dde120600@mail.ruRussian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииBashlyaeva Children’s City Clinical Hospital of the Moscow City Health Care DepartmentГБУЗ г. Москвы «Детская городская клиническая больница им. З.А. Башляевой Департамента здравоохранения г. Москвы»Khimki Central Clinical HospitalПоликлиника «Мама и малыш» ГАУЗ МО «Химкинская центральная клиническая больница»Mommy and Baby Outpatient clinic of Khimki Central Clinical HospitalГАУЗ МО «Химкинская центральная клиническая больница»Northern State Medical UniversityФГБОУ ВО «Северный государственный медицинский университет» Минздрава России0806202418140706202407062024Copyright ©; 2024, Consilium MedicumCopyright ©; 2024, ООО "Консилиум Медикум"2024Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://pediatria.orscience.ru/2658-6630/article/view/633320

Cesarean section is one of the most common operations in obstetrics and gynecology. However, despite the widespread use of this procedure, it is associated with certain risks for the mother and the child. As a result of cesarean section (CS), newborns do not acquire some important microorganisms during the passage of the maternal birth canal, which can impact the development and alter the functioning of the microbial ecosystem of the child. The gut microbiota plays an essential role in maintaining human health. It promotes digestion, strengthens the immune system, and produces some vitamins. Recent studies show that the intestinal microbiota of children born with CS differs from that of children born naturally. This article addresses the consequences of this difference on children's health and available ways of correcting the intestinal microbiota composition in children born via CS. Understanding the mechanisms of gut microbiota formation and function in these children can help develop effective strategies to prevent and treat various diseases associated with gut microbiota imbalance.

Кесарево сечение – одна из самых распространенных операций в акушерстве и гинекологии. Однако, несмотря на широкое использование этой процедуры, она не лишена определенных рисков не только для матери, но и для ребенка. В результате операции кесарева сечения (КС) новорожденные не получают целый ряд важных микроорганизмов при прохождении родовых путей матери, что может привести к нарушению развития и функционирования микробной экосистемы ребенка. Микробиота кишечника играет важную роль в поддержании здоровья человека. Она способствует пищеварению, укреплению иммунной системы и синтезу некоторых витаминов. Исследования последних лет показывают, что кишечная микробиота детей, рожденных при помощи КС, отличается от той, которая формируется у детей, рожденных естественным путем. В статье рассмотрим последствия этого различия для здоровья детей, а также возможности коррекции состава кишечной микробиоты у детей после КС. Понимание механизмов формирования и функционирования кишечной микробиоты у этих детей может помочь разработать эффективные стратегии профилактики и лечения различных заболеваний, связанных с нарушением баланса кишечной микробиоты.

cesarean sectionnewborn microbiotamicrobiomeintestinal microbiotaкесарево сечениемикробиота новорожденногомикробиомкишечная микробиотаИсенова С.Ш., Бодыков Г.Ж., Кабыл Б.К., и др. Особенности операции кесарева сечения на современном этапе. Вестник КазНМУ. 2019;1:13-16 [Isenova SSh, Bodykov GZh, Kabyl BK, et al. Features of cesarean section at the present stage. Vestnik KazNMU. 2019;1:13-6 (in Russian)].Antoine C, Young BK. Cesarean section one hundred years 1920-2020: the Good, the Bad and the Ugly. J Perinat Med. 2020;49(1):5-16. DOI:10.1515/jpm-2020-0305Bhatia M, Banerjee K, Dixit P, Dwivedi LK. Assessment of Variation in Cesarean Delivery Rates Between Public and Private Health Facilities in India from 2005 to 2016. JAMA Netw Open. 2020;3(8): e2015022. DOI:10.1001/jamanetworkopen.2020.15022Long Q, Kingdon C, Yang F, et al. Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review. PLoS Med. 2018;15(10): e1002672. DOI:10.1371/journal.pmed.1002672Yasseen III AS, Bassil K, Sprague A, et al. Late preterm birth and previous cesarean section: a population-based cohort study. J Matern Fetal Neonatal Med. 2019;32(14):2400-7. DOI:10.1080/14767058.2018.1438397Sotiriadis A, Makrydimas G, Papatheodorou S, et al. Corticosteroids for preventing neonatal respiratory morbidity after elective caesarean section at term. Cochrane Database Syst Rev. 2018;8(8): CD006614. DOI:10.1002/14651858.CD006614.pub3Bäckhed F, Roswall J, Peng Y, et al. Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. Cell Host Microbe. 2015;17(5):690-703. DOI:10.1016/j.chom.2015.04.004Koleva PT, Kim JS, Scott JA, Kozyrskyj AL. Microbial programming of health and disease starts during fetal life. Birth Defects Res C Embryo Today. 2015;105(4):265-77. DOI:10.1002/bdrc.21117Larabi A, Barnich N, Nguyen HTT. New insights into the interplay between autophagy, gut microbiota and inflammatory responses in IBD. Autophagy. 2020;16(1):38-51. DOI:10.1080/15548627.2019.1635384Zhou GQ, Huang MJ, Yu X, et al. Early life adverse exposures in irritable bowel syndrome: new insights and opportunities. Front Pediatr. 2023;11:1241801. DOI:10.3389/fped.2023.1241801Espírito Santo C, Caseiro C, Martins MJ, et al. Gut Microbiota, in the Halfway between Nutrition and Lung Function. Nutrients. 2021;13(5):1716. DOI:10.3390/nu13051716Asadi A, Shadab Mehr N, Mohamadi MH, et al. Obesity and gut-microbiota-brain axis: A narrative review. J Clin Lab Anal. 2022;36(5): e24420. DOI:10.1002/jcla.24420Sorboni SG, Moghaddam HS, Jafarzadeh-Esfehani R, Soleimanpour S. A Comprehensive Review on the Role of the Gut Microbiome in Human Neurological Disorders. Clin Microbiol Rev. 2022;35(1): e0033820. DOI:10.1128/CMR.00338-20Vallès Y, Artacho A, Pascual-García A, et al. Microbial succession in the gut: directional trends of taxonomic and functional change in a birth cohort of Spanish infants. PLoS Genet. 2014;10(6): e1004406. DOI:10.1371/journal.pgen.1004406Ihekweazu FD, Versalovic J. Development of the Pediatric Gut Microbiome: Impact on Health and Disease. Am J Med Sci. 2018;356(5):413-23. DOI:10.1016/j.amjms.2018.08.005Funkhouser LJ, Bordenstein SR. Mom knows best: the universality of maternal microbial transmission. PLoS Biol. 2013;11(8): e1001631. DOI:10.1371/journal.pbio.1001631Collado MC, Rautava S, Aakko J, et al. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep. 2016;6:23129. DOI:10.1038/srep23129DiGiulio DB, Romero R, Amogan HP, et al. Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation. PLoS One. 2008;3(8): e3056. doi:10.1371/journal.pone.0003056Moore RE, Townsend SD. Temporal development of the infant gut microbiome. Open Biol. 2019;9(9):190128. DOI:10.1098/rsob.190128Azad MB, Konya T, Maughan H, et al; CHILD Study Investigators. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. CMAJ. 2013;185(5):385-94. DOI:10.1503/cmaj.121189Chu DM, Ma J, Prince AL, et al. Maturation of the infant microbiome community structure and function across multiple body sites and in relation to mode of delivery. Nat Med. 2017;23(3):314-26. DOI:10.1038/nm.4272Browne HP, Shao Y, Lawley TD. Mother-infant transmission of human microbiota. Curr Opin Microbiol. 2022;69:102173. DOI:10.1016/j.mib.2022.102173Mold JE, Michaëlsson J, Burt TD, et al. Maternal alloantigens promote the development of tolerogenic fetal regulatory T cells in utero. Science. 2008;322(5907):1562-5. DOI:10.1126/science.1164511Dominguez-Bello MG, Costello EK, Contreras M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA. 2010;107(26):11971-5. DOI:10.1073/pnas.1002601107Rutayisire E, Huang K, Liu Y, Tao F. The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants’ life: a systematic review. BMC Gastroenterol. 2016;16(1):86. DOI:10.1186/s12876-016-0498-0Zhou P, Manoil D, Belibasakis GN, Kotsakis GA. Veillonellae: Beyond Bridging Species in Oral Biofilm Ecology. Front Oral Health. 2021;2:774115. DOI:10.3389/froh.2021.774115Hewitt KM, Mannino FL, Gonzalez A, et al. Bacterial diversity in two Neonatal Intensive Care Units (NICUs). PLoS One. 2013;8(1): e54703. DOI:10.1371/journal.pone.0054703Putignani L, Carsetti R, Signore F, Manco M. Additional maternal and nonmaternal factors contribute to microbiota shaping in newborns. Proc Natl Acad Sci USA. 2010;107(42): E159; author reply E160. DOI:10.1073/pnas.1010526107Biasucci G, Benenati B, Morelli L, et al; Cesarean delivery may affect the early biodiversity of intestinal bacteria. J Nutr. 2008;138(9):1796S-800S. DOI:10.1093/jn/138.9.1796SBokulich NA, Chung J, Battaglia T, et al: Antibiotics, birth mode, and diet shape microbiome maturation during early life. Sci Transl Med. 2016;8(343):343ra82. DOI:10.1126/scitranslmed.aad7121Butel MJ, Waligora-Dupriet AJ, Wydau-Dematteis S. The developing gut microbiota and its consequences for health. J Dev Orig Health Dis. 2018;9(6):590-7. DOI:10.1017/S2040174418000119Salminen S, Gibson GR, McCartney AL, Isolauri E. Influence of mode of delivery on gut microbiota composition in seven year old children. Gut. 2004;53(9):1388-9. DOI:10.1136/gut.2004.041640Stokholm J, Thorsen J, Chawes BL, et al. Cesarean section changes neonatal gut colonization. J Allergy Clin Immunol. 2016;138(3):881-9.e2. DOIdoi:10.1016/j.jaci.2016.01.028Nuriel-Ohayon M, Neuman H, Ziv O, et al. Progesterone increases Bifidobacterium relative abundance during late pregnancy. Cell Rep. 2019;27(3):730-6.e3. DOI:10.1016/j.celrep.2019.03.075Korpela K, Salonen A, Vepsäläinen O, et al. Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants. Microbiome. 2018;6(1):182. DOI:10.1186/s40168-018-0567-4Azad MB, Konya T, Persaud RR, et al; CHILD Study Investigators. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG. 2016;123(6):983-93. DOI:10.1111/1471-0528.13601Korpela K, Helve O, Kolho KL, et al. Maternal Fecal Microbiota Transplantation in Cesarean-Born Infants Rapidly Restores Normal Gut Microbial Development: A Proof-of-Concept Study. Cell. 2020;183(2):324-34.e5. DOI:10.1016/j.cell.2020.08.047Wilson BC, Butler ÉM, Grigg CP, et al. Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial. EBioMedicine. 2021;69:103443. DOI:10.1016/j.ebiom.2021.103443Yektaei-Karin E, Moshfegh A, Lundahl J, et al. The stress of birth enhances in vitro spontaneous and IL-8-induced neutrophil chemotaxis in the human newborn. Pediatr Allergy Immunol. 2007;18(8):643-51. DOI:10.1111/j.1399-3038.2007.00578.xShi X, Ma W, Duan S, et al. Single-cell transcriptional diversity of neonatal umbilical cord blood immune cells reveals neonatal immune tolerance. Biochem Biophys Res Commun. 2022;608:14-22. DOI:10.1016/j.bbrc.2022.03.132Ly NP, Ruiz-Perez B, Onderdonk AB, et al: Mode of delivery and cord blood cytokines: a birth cohort study. Clin Mol Allergy. 2006;4:13. DOI:10.1186/1476-7961-4–13Gillis CC, Hughes ER, Spiga L, et al. Dysbiosis-Associated Change in Host Metabolism Generates Lactate to Support Salmonella Growth. Cell Host Microbe. 2018;23(1):54-64.e6. DOI:10.1016/j.chom.2017.11.006Sevelsted A, Stokholm J, Bønnelykke K, Bisgaard H. Cesarean section and chronic immune disorders. Pediatrics. 2015;135(1): e92-8. DOI:10.1542/peds.2014-0596Prentice AM. Breastfeeding in the Modern World. Ann Nutr Metab. 2022;78(Suppl. 2):29-38. DOI:10.1159/000524354Le Doare K, Holder B, Bassett A, Pannaraj PS. Mother’s Milk: A Purposeful Contribution to the Development of the Infant Microbiota and Immunity. Front Immunol. 2018;9:361. DOI:10.3389/fimmu.2018.00361Stewart CJ, Ajami NJ, O’Brien JL, et al. Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature. 2018;562(7728):583-8. DOI:10.1038/s41586-018-0617-xVandenplas Y, Berger B, Carnielli VP, et al. Human Milk Oligosaccharides: 2’-Fucosyllactose (2’-FL) and Lacto-N-Neotetraose (LNnT) in Infant Formula. Nutrients. 2018;10(9):1161. DOI:10.3390/nu10091161Hobbs AJ, Mannion CA, McDonald SW, et al. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth. 2016;16:90. DOI:10.1186/s12884-016-0876-1Maharlouei N, Pourhaghighi A, Raeisi Shahraki H, et al. Factors Affecting Exclusive Breastfeeding, Using Adaptive LASSO Regression. Int J Community Based Nurs Midwifery. 2018;6(3):260-71.Dunn AB, Jordan S, Baker BJ, Carlson NS. The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN Am J Matern Child Nurs. 2017;42(6):318-25. DOI:10.1097/NMC.0000000000000373Juan J, Zhang X, Wang X, et al. Association between Skin-to-Skin Contact Duration after Caesarean Section and Breastfeeding Outcomes. Children (Basel). 2022;9(11):1742. DOI:10.3390/children9111742Karimi FZ, Miri HH, Khadivzadeh T, Maleki-Saghooni N. The effect of mother-infant skin-to-skin contact immediately after birth on exclusive breastfeeding: a systematic review and meta-analysis. J Turk Ger Gynecol Assoc. 2020;21(1):46-56. DOI:10.4274/jtgga.galenos.2019.2018.0138Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review. Heliyon. 2023;9(6): e16235. DOI:10.1016/j.heliyon.2023.e16235Lagerberg D, Wallby T, Magnusson M. Differences in breastfeeding rate between mothers delivering by caesarean section and those delivering vaginally. Scand J Public Health. 2021;49(8):899-903. DOI:10.1177/1403494820911788De Silva D, Halken S, Singh C, et al; European Academy of Allergy, Clinical Immunology Food Allergy, Anaphylaxis Guidelines Group. Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials. Pediatr Allergy Immunol. 2020;31(7):813-26. DOI:10.1111/pai.13273Halken S, Muraro A, de Silva D, et al; European Academy of Allergy and Clinical Immunology Food Allergy and Anaphylaxis Guidelines Group. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol. 2021;32(5):843-58. DOI:10.1111/pai.13496Berseth CL, Johnston WH, Stolz SI, et al. Clinical response to 2 commonly used switch formulas occurs within 1 day. Clin Pediatr (Phila). 2009;48(1):58-65. DOI:10.1177/0009922808321897De Almagro García MC, Moreno Muñoz JA, Jiménez López J, Rodríguez-Palmero Seuma M. Nuevos ingredientes en fórmulas infantiles. Beneficios sanitarios y funcionales [New ingredients in infant formula. Health and functional benefits]. Nutr Hosp. 2017;34(Suppl. 4):8-12. [Article in Spanish]. DOI:10.20960/nh.1564Захарова И.Н., Оробинская Я.В., Сугян Н.Г., и др. Олигосахариды грудного молока: что мы знаем о них сегодня? Педиатрия. Consilium Medicum. 2022;3:204-12 [Zakharova IN, Orobinskaia IaV, Sugian NG, et al. Breast milk oligosaccharides: what do we know today? Pediatrics. Consilium Medicum. 2022;3:204-12 (in Russian)]. DOI:10.26442/26586630.2022.3.201851Reverri EJ, Devitt AA, Kajzer JA, et al. Review of the Clinical Experiences of Feeding Infants Formula Containing the Human Milk Oligosaccharide 2’-Fucosyllactose. Nutrients. 2018;10(10):1346. DOI:10.3390/nu10101346Goehring KC, Marriage BJ, Oliver JS, et al. Similar to Those Who Are Breastfed, Infants Fed a Formula Containing 2’-Fucosyllactose Have Lower Inflammatory Cytokines in a Randomized Controlled Trial. J Nutr. 2016;146(12):2559-66. DOI:10.3945/jn.116.236919Ramirez-Farias C, Baggs GE, Marriage BJ. Growth, Tolerance, and Compliance of Infants Fed an Extensively Hydrolyzed Infant Formula with Added 2’-FL Fucosyllactose (2’-FL) Human Milk Oligosaccharide. Nutrients. 2021;13(1):186. DOI:10.3390/nu13010186Vázquez E, Van den Abbeele P, Marzorati M, Chow JM, Buck R., The Human Milk Oligosaccharide 2´-Fucosyllactose and The Prebiotic scFOS Have Synergistic Effects Modulating the Infant Gut Microbiota. 5th Nutrition & Growth Conference 2018, ParisJungersen M, Wind A, Johansen E, et al. The Science behind the Probiotic Strain Bifidobacterium animalis subsp. lactis BB-12(®). Microorganisms. 2014;2(2):92-110. DOI:10.3390/microorganisms2020092Gazzolo D, Picone S, Gaiero A, et al. Early Pediatric Benefit of Lutein for Maturing Eyes and Brain-An Overview. Nutrients. 2021;13(9):3239. DOI:10.3390/nu13093239Miranda-Dominguez O, Ramirez JSB, Mitchell AJ, et al. Carotenoids improve the development of cerebral cortical networks in formula-fed infant macaques. Sci Rep. 2022;12(1):15220. DOI:10.1038/s41598-022-19279-1