Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy

van Nimwegen, Frederika A., Penders, John, Stobberingh, Ellen E., Postma, Dirkje S., Koppelman, Gerard H., Kerkhof, Marjan, Reijmerink, Naomi E., Dompeling, Edward, van den Brandt, Piet A., Ferreira, Isabel, Mommers, Monique and Thijs, Carel (2011) Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy. Journal of Allergy and Clinical Immunology, 128 5: 948-955, e3. doi:10.1016/j.jaci.2011.07.027

Author van Nimwegen, Frederika A.
Penders, John
Stobberingh, Ellen E.
Postma, Dirkje S.
Koppelman, Gerard H.
Kerkhof, Marjan
Reijmerink, Naomi E.
Dompeling, Edward
van den Brandt, Piet A.
Ferreira, Isabel
Mommers, Monique
Thijs, Carel
Title Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy
Journal name Journal of Allergy and Clinical Immunology   Check publisher's open access policy
ISSN 0091-6749
Publication date 2011-01-01
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.jaci.2011.07.027
Open Access Status DOI
Volume 128
Issue 5
Start page 948
End page 955, e3
Total pages 11
Place of publication Philadelphia, PA United States
Publisher Mosby
Language eng
Abstract Background: Both gastrointestinal microbiota composition and cesarean section have been linked to atopic manifestations. However, results are inconsistent, and the hypothesized intermediate role of the microbiota in the association between birth mode and atopic manifestations has not been studied yet. Objectives: We sought to investigate the relationship between microbiota composition, mode and place of delivery, and atopic manifestations. Methods: The Child, Parent and Health: Lifestyle and Genetic Constitution Birth Cohort Study included data on birth characteristics, lifestyle factors, and atopic manifestations collected through repeated questionnaires from birth until age 7 years. Fecal samples were collected at age 1 month (n = 1176) to determine microbiota composition, and blood samples were collected at ages 1 (n = 921), 2 (n = 822), and 6 to 7 (n = 384) years to determine specific IgE levels. Results: Colonization by Clostridium difficile at age 1 month was associated with wheeze and eczema throughout the first 6 to 7 years of life and with asthma at age 6 to 7 years. Vaginal home delivery compared with vaginal hospital delivery was associated with a decreased risk of eczema, sensitization to food allergens, and asthma. After stratification for parental history of atopy, the decreased risk of sensitization to food allergens (adjusted odds ratio, 0.52; 95% CI, 0.35-0.77) and asthma (adjusted odds ratio, 0.47; 95% CI, 0.29-0.77) among vaginally home-born infants was only found for children with atopic parents. Mediation analysis showed that the effects of mode and place of delivery on atopic outcomes were mediated by C difficile colonization. Conclusion: Mode and place of delivery affect the gastrointestinal microbiota composition, which subsequently influences the risk of atopic manifestations.
Keyword Asthma
Cesarean section
Cohort Study
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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Created: Thu, 21 May 2015, 02:37:15 EST by Isabel Ferreira on behalf of School of Public Health