Impact of Postpartum Hospital Length-of-Stay on Infant Gut Microbiota: A
Comprehensive Analysis of Vaginal and Caesarean birth
Abstract
Objectives This study aimed to assess the association between
postpartum hospital length-of-stay and the composition of gut microbiota
at 3 and 12 months of age in different birth modes. Design
Prospective cohort of Canadian infants from the Canadian Healthy Infant
Longitudinal Development (CHILD) Study born between 2008 and 2012.
Setting General community. Sample 1313 infants from
three study sites (Edmonton, Vancouver, and Winnipeg) of the CHILD
cohort Methods Duration of hospital stay was documented in
hospital records. Infants’ gut microbiota was characterized by Illumina
16S rRNA sequencing of fecal samples at 3 and 12 months. Main
outcome measures Infant gut microbiota profiles. Results: In
the absence of maternal intrapartum antibiotic (IAP) exposure, vaginally
delivered infants (VD) with a longer hospital length-of-stay (LOS) had a
higher abundance of bacteria in their gut known to cause
hospital-acquired Infections (HAI), including Enterococcus at 3
months and 12 months and Citrobacter at 3 months of age.
Moreover, HAI-causing bacteria Enterobacteriaceae were more abundant in
later infancy in postnatal prolonged hospital stayed IAP-exposed
caesarean section (CS) infants. Enterococcus or
Citrobacter abundance at 3 months significantly mediated the
association of LOS with low relative abundance of Bacteroidaceae and a
high relative abundance of Enterococcaeae/Bacteriodaceae or
Enterobacteriaceae/Bacteroidaceae ratio at 12 months of age in VD
infants without IAP exposure. Conclusions LOS after birth is
associated with infant gut dysbiosis. Further research is needed to
explore the health outcomes of these associations.