Are Vaginal Microbiota Transplantation Interventions Beneficial for Neurodevelopment in Infants Delivered by Caesarean Section?

In a recent study published in cell host microorganisminvestigators investigated the effects of vaginal microbiota transfer (VMT) on neurodevelopment in infants born by cesarean section (cesarean section).

Background

Studies have found links between caesarean sections and likely adverse health effects in children, including immune, metabolic, and neurodevelopmental disorders. One study suggests that VMT for newborns through exposure to maternal vaginal fluids may help reverse microbiome disturbances caused by caesarean section. To assess whether a VMT intervention can improve outcomes in cesarean-born infants, a triplicate study to determine the effects of her VMT intervention on neurodevelopment, gut microbiota, and metabolome in cesarean-born infants A blinded RCT was conducted.

About research

The study was conducted at the Seventh Affiliated Hospital of Southern Medical University in Southern China, and screened 87 pregnant women scheduled for cesarean section from December 10, 2020 to July 27, 2021. Of these, 76 were randomly tested. Classified as either VMT or control (Con) cohorts. Approximately 68 infants were studied for 42 days after birth and analyzed for microbiome and metabolome.

Neurodevelopment was assessed in 57 6-month-old infants and 46 3-month-old infants using the Age and Stage Questionnaire, Third Edition (ASQ-3). ASQ-3 consists of five subdomains including gross motor skills, communication, problem solving, personal social skills, and fine motor skills.

Overall, neurodevelopment was represented using the sum of scores from the five subdomains. In this study, we estimated neurodevelopment in infants at 3 and 6 months of age and considered the total score at 6 months as the primary outcome. The secondary outcome measures of this study consisted of his ASQ-3 total score observed after 3 months and subdomain scores at 3 months and his 6 months.

In this study, maternal vaginal swabs were collected at enrollment and analyzed using the 16S ribosomal ribonucleic acid (rRNA) gene. In addition, we measured the intestinal microbiota of infants by analyzing the fecal 16S rRNA gene sequences of infants at 3, 7, 30 and 42 days of age. The infant gut microbial component occupied by maternal vaginal fluid was estimated.

result

This study found that most clinical features were similar between the VMT cohort and the Con group, except that the VMT group had a lower gestational age than the Con group. The mean maternal age of the VMT group was 31.88 ± 4.32 years, while the mean maternal age of the Con group was 31.67 ± 5.03 years. All caesarean mothers received prophylactic antibiotics after removal of the vaginal gauze.

The research team found no notable differences in per capita monthly household income, pregnancy complications, neonatal birth weight, pre-pregnancy body mass index (BMI), maternal education, or type of feeding in the Con and VMT groups. noted that it was not seen. During the early stages of pregnancy, none of the participants had an infection or fever, and were not taking antibiotics, antipyretics, or antivirals. None of the women in either group drank alcohol or smoked during pregnancy.

Evaluation of maternal vaginal swabs showed that lactobacilli were the predominant bacteria present in the participants’ reproductive tracts. ASQ-3 scores at 3 months were positively correlated with ASQ-3 scores at 6 months, suggesting that this index is relatively stable. The VMT group also showed a significant 10.09% increase in ASQ-3 total score after 6 months compared to the Con group.

At 3 months, the VMT group had significantly higher ASQ-3 total scores compared with the Con group. Also, at 3 months, infants who received VMT had higher scores in the communicative and total motor subdomains of ASQ-3 compared with infants who did not receive VMT. Furthermore, the VMT group had significantly higher total motor subdomain scores than the Con group at 6 months. In this study, we found that after adjusting for gestational age, the VMT and Con cohorts showed significant differences in neurodevelopment. In addition, the VMT group had higher scores in the personal-social and fine motor subdomains at his 6-month time point.

Preliminary findings showed that the VMT group had significantly higher abundance of maternal vaginal bacteria in the infant’s gut microbiome at 30 and 42 days compared to the Con group. This suggests that VMT resulted in more migration of the microbiome from the maternal vaginal fluid to the infant. . The VMT group showed a higher percentage of mature microbiota compared to the Con group. The research team also noted that the vaginal delivery group had a more developed microbiota compared to the caesarean section cohort.

Conclusion

Our study shows that VMT can be a safe approach to promote neurodevelopment in infants and partially restore the gut microbiome of caesarean-delivered infants in healthy pregnant women. Further research is needed to elucidate the specific mechanisms that provide these positive effects.

The investigators believe that despite VMT’s low cost, general acceptance, and high safety potential, its introduction in the clinical setting requires adherence to well-defined protocols and indications. increase. Extensive research is also needed to investigate the permanent effects of VMT and individual responses to this approach on a larger scale.