The prevalence of Caesarian sections has increased in industrialised countries significantly over recent decades, from 15% in 1990 to 27% in 2011. For the scientific and medical communities this worrisome, as C-section deliveries have been associated with numerous health issues for children, including respiratory distress after birth, greater risk of infection, as well as long term problems such as the development of asthma in later life.


Many clinical trials in recent years have drawn strong correlations between a child's mode of delivery and the development of their microbiota and immune system. Now a new study from the Netherlands has added to those findings. The group of Dutch researchers say that, depending on the mode of a child's birth, they are either exposed to the mother's natural microbiota via the vaginal canal, or their are exposed to skin and environmental bacteria through Caesarian section. This early exposure is thought to have a large impact on how our microbiota developments and how our immune systems mature though the time frame for these developments are largely unknown.

In this recent study, Dutch researchers were keen to investigate how C-section births specifically impacted on the bacteria in the upper respiratory tract. This is a natural niche area of the body for opportunistic pathogens and is often the origin of recurrent infections. In previous studies, large sampling of children revealed a highly dynamic composition of bacteria in the upper respiratory tract. The team were keen to find out how early exposure to bacteria after birth impacted on this area of the body specifically, and how vaginal or C-section deliveries created different bacterial communities.

The research team observed a group of 102 healthy children from birth until 6 months of age. The team found that the development of the respiratory bacteria starts developing straight after birth. Interestingly, within the first day of life all the children had a Streptococcus viridans-predominated profile, regardless of their delivery. However, during the first week of life rapid differentiation developed between the groups. Initially within most infants, Staphylococcus aureus predominated followed by other communities. Those children born via C-section showed a delayed overall development of microbial communities and specifically reduced health-associated microbes which were present in children born naturally. The research team thinks that this has an influence on respiratory health later in life.

So it seems that the mode of delivery not only has associations with the composition and diversity of the gut microbiota, but studies such as this show it may also impact on microbial communities elsewhere in the body.

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Reference: Bosch, A, et al (2016) Development of Upper Respiratory Tract Microbiota in Infancy is Affected by Mode of Delivery. EBioMedicine.


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