Abstract:
C-section is crucial in reducing maternal and neonatal mortality when medically indicated, but one of its side effects could be the disruption of vertical transmission of maternal-infant microbiota during delivery, potentially leading to gut dysbiosis and increased disease risks in C-section infants. To address such dysbiosis, it seems reasonable to supplement \"what is missing\" during C-section procedure. This idea has prompted several clinical trials, including proof-of-concept, investigating interventions like vaginal microbial seeding, oral administration of maternal vaginal microbes and even oral administration of maternal fecal materials. Hereby, we have summarized these trials to help understand the current state of these researches, highlighting the predominantly pilot nature of most of these studies and emphasizing the need for well-designed studies with larger sample to guide evidence-based medicine in the future.
C-section is associated with gut dysbiosis in CS infants and increased disease risks from childhood to adulthood.Apart from using traditional probiotics to restore CS-related dysbiosis, a new research direction is to investigate the potential of mimicking natural inoculation process would alleviate infant gut dysbiosis.Several small-scale studies have shown that transplanting maternal vaginal or even fecal microbiota might restore CS-related infant dysbiosis. Controversy remains regarding the clinical applicability, safety, efficacy and mechanisms of these approaches.
摘要:
剖腹产对于降低孕产妇和新生儿死亡率至关重要,但其副作用之一可能是分娩过程中母婴微生物群垂直传播的中断,可能导致剖腹产婴儿肠道菌群失调和疾病风险增加。为了解决这种生态失调,在剖腹产过程中补充“缺少什么”似乎是合理的。这个想法促使了一些临床试验,包括概念验证,调查阴道微生物接种等干预措施,口服母体阴道微生物,甚至口服母体粪便。特此,我们总结了这些试验,以帮助了解这些研究的现状,强调大多数这些研究的主要试点性质,并强调需要精心设计的更大样本的研究,以指导未来的循证医学。
剖腹产与CS婴儿的肠道菌群失调有关,并增加从儿童到成年的疾病风险。除了使用传统的益生菌来恢复CS相关的菌群失调,一个新的研究方向是探讨模拟自然接种过程缓解婴儿肠道菌群失调的潜力。一些小规模研究表明,移植母体阴道甚至粪便微生物群可能会恢复CS相关的婴儿菌群失调。关于临床适用性仍然存在争议,安全,这些方法的功效和机制。