The maternal microbiome in pregnancy, delivery, and early-stage development of neonatal microbiome after cesarean section: A prospective longitudinal study

Philipp Foessleitner, Petra Pjevac, Sonja Granser, Lukas Wisgrill, Lisa Pummer, Fanny Eckel, David Seki, David Berry, Bela Hausmann, Alex Farr (Corresponding author)

Publications: Contribution to journalArticlePeer Reviewed

Abstract

Introduction: Changes within the maternal microbiome during the last trimester of pregnancy and the determinants of the subsequent neonatal microbiome establishment after delivery by elective cesarean section are described. Material and methods: Maternal vaginal and rectal microbiome samples were collected in the last trimester and before cesarean section; intrauterine cavity, placenta, neonatal buccal mucosa, skin, and meconium samples were obtained at birth; neonatal sample collection was repeated 2–3 days postnatally. Microbial community composition was analyzed by 16S rRNA gene amplicon sequencing. Relative abundance measurements of amplicon sequencing variants and sum counts at higher taxonomic levels were compared to test for significant overlap or differences in microbial community compositions. ClinicalTrials.gov ID: NCT04489056. Results: A total of 30 mothers and their neonates were included with available microbiome samples for all maternal, intrauterine cavity and placenta samples, as well as for 18 of 30 neonates. The composition of maternal vaginal and rectal microbiomes during the last trimester of healthy pregnancies did not significantly change (permutational multivariate analysis of variance [PERMANOVA], p > 0.05). No robust microbial signature was detected in the intrauterine cavity, placenta, neonatal buccal mucosa, skin swabs, or meconium samples collected at birth. After birth, the neonatal microbiome was rapidly established, and significantly different microbial communities were detectable 2–3 days postnatally in neonate buccal mucosa and stool samples (PERMANOVA, p < 0.01). Conclusions: Maternal vaginal and rectal microbiomes in healthy pregnancies remain stable during the third trimester. No microbial colonization of the neonate was observed before birth in healthy pregnancies. Neonatal microbiomes in infants delivered by cesarean section displayed a taxonomic composition distinct from maternal vaginal and rectal microbiomes at birth, indicating that postnatal exposure to the extrauterine environment is the driving source of initial neonatal microbiome development in this cohort.

Original languageEnglish
Pages (from-to)832-841
Number of pages10
JournalActa Obstetricia et Gynecologica Scandinavica
Volume103
Issue number5
Early online date24 Jan 2024
DOIs
Publication statusPublished - May 2024

Austrian Fields of Science 2012

  • 106026 Ecosystem research
  • 106022 Microbiology
  • 106059 Microbiome research

Keywords

  • healthy pregnancy
  • microbial community assembly
  • neonatal microbiome
  • placental microbiome
  • rectal microbiome
  • vaginal microbiome

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