Monday, September 23, 2019

Baby gut study finds bacteria different after C-section births

A huge study of babies' stool samples has found key differences between infants born vaginally and via Caesarean section, offering clues about the development of the human immune system, researchers said on Wednesday.

Vaginally born babies got most of their gut bacteria from their mother, but C-section babies did not and had more bacteria linked to the hospital around them, the study found.

It is not clear what impact the difference may have on children's future health, and the findings should not deter women from having C-section births, the scientists leading the work said.

But the so-called "baby biome" project - the world's largest such study - had opened a window on a little-understood stage in the development of human immunity, they added.

"The first weeks of life are a critical window of development of the baby's immune system, but we know very little about it," said a professor who co-led the study.

"We need to follow up ... these babies as they grow to see if early differences in the microbiome lead to any health issues."

The gut microbiome is a complex ecosystem of millions of microbes and is thought by scientists to be important for how the immune system develops.

Previous research has suggested that a lack of exposure to some microbes in early life is implicated in autoimmune diseases such as asthma, allergies and diabetes.

But scientists have not yet been able to work out how important the initial gut microbiome - or "baby biome" - is to future immunity and health, or how a baby's microbiome develops, or what happens to it with different modes of birth.

In this research,  scientists  used DNA sequencing to analyse more than 1,600 gut bacteria samples from 175 mothers and almost 600 babies.


In samples from mothers and from the babies at four, seven and 21 days old, the team found there was a significant difference between the two delivery methods - with vaginally delivered babies having many more health-associated bacteria from their mothers than babies born by Caesarean.

In place of some of the mother's bacteria, the C-section babies had more bacteria typically found in hospitals, the researchers said, and these bugs were also more likely to be drug-resistant.

"At the moment we don't understand the long-term consequences of this," the researcher said at a briefing about the results. "It's clearly complex and we're only just beginning to scratch the surface."


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Monday, May 07, 2018

Is vaginal birth risky after cesarean delivery?

Scientists along with researchers from various other institutions, decided to explore if vaginal birth is risky after having a cesarean in the previous pregnancy and its probable answers. It was found that attempted vaginal birth after cesarean (VBAC) is associated with higher rates of adverse effects or death for mothers and infants.

Although absolute rates were low in mothers who attempted this type of birth.

“The absolute rates of adverse maternal and neonatal outcomes are low with both attempted VBAC and elective repeat cesarean delivery,” said a researcher. “Both are reasonable options for women in general; however, attempted VBAC continues to be associated with higher relative rates of severe adverse maternal and neonatal outcomes compared with an elective repeat cesarean delivery.”

For women who have had a single previous cesarean section, the best mode of delivery in a later pregnancy is controversial, as there are risks and benefits to attempting a VBAC or having an elective repeat cesarean section.

Attempted VBAC is associated with a higher risk of uterine rupture, haemorrhage and other maternal and infant complications. Repeat cesarean sections are associated with an increased risk of surgical complications and placental complications in subsequent pregnancies. It is also difficult to predict which patients will have a successful VBAC.

Planning mode of delivery for women with a previous cesarean delivery is, therefore, challenging for both the patient and her care provider. 

Researchers conducted a study using information on all women in Canada (excluding Quebec) who had a previous cesarean delivery and subsequently delivered between 2003 and 2015.

The study found that although the number of women with a previous cesarean delivery increased from 2003 to 2014, rates of attempted VBAC and success rates after attempting labour were essentially unchanged.
“This topic is an important issue because rates of cesarean section continue to rise and the most common single indication for a cesarean delivery is a prior cesarean delivery,” said a Dr. “Once a woman has had two cesarean deliveries, she is very unlikely to have a subsequent vaginal delivery due to high maternal and neonatal risks associated with labour.”

The authors also found that infant, but not maternal, outcomes, have worsened between 2003 and 2015 after attempted VBAC.

The study highlighted the importance of appropriate patient selection for attempting VBAC and careful monitoring of labour and delivery to optimize safety for these women and their infants.

“For women who may be candidates for an attempted VBAC, the choice between an elective repeat cesarean delivery and an attempted VBAC depends on the woman’s desire for a vaginal delivery, her tolerance for risk and whether she is planning a small or large family,” says the Dr.

ps- I had my first delivery through C-section, but the 2nd delivery was normal, though I was kept prepared for another C-section, as I started bleeding. But, luckily, my son was born before the time set for cesarean ! Thank God, both are normal and fine.

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