Mode of delivery strongly influences the early infant gut microbiome. Children born by cesarean section (C-section) lack Bacteroides species until 6–18 months of age. One hypothesis is that these differences stem from lack of exposure to the maternal vaginal microbiome. Here, we re-evaluate this hypothesis by comparing the microbial profiles of 75 infants born vaginally or by planned versus emergent C-section. Multiple children born by C-section have a high abundance of Bacteroides in their first few days of life, but at 2 weeks, both C-section groups lack Bacteroides (primarily according to 16S sequencing), despite their difference in exposure to the birth canal. Finally, a comparison of microbial strain profiles between infants and maternal vaginal or rectal samples finds evidence for mother-to-child transmission of rectal rather than vaginal strains. These results suggest differences in colonization stability as an important factor in infant gut microbiome composition rather than birth canal exposure.
Week 1 gut microbiota does not differ between infants born vaginally versus C-section
Week 2 gut microbiota of C-section infants lacks Bacteroides
Microbiota of infants born by C-section after labor resembles scheduled C-section
Bacterial strains in infants match maternal rectal rather than vaginal strains
Mitchell et al. compare early-life infant gut microbiota by delivery mode, suggesting early colonization by Bacteroides regardless of delivery mode, but loss of Bacteroides by 2 weeks in C-section-delivered infants, whether or not exposed to the vagina in labor. Infant strains matched maternal rectal rather vaginal strains.