Research press release





今回、Trevor Lawleyたちの研究グループは、英国の病院で生まれた満期産児(596例)の腸内微生物相の全ゲノム塩基配列解読を行い、帝王切開による出産によって新生児期の微生物相の組成がどのように形成されるのかを調べた。調査した乳児のうち、314例が経腟分娩で、282例が帝王切開による分娩だった。分析の結果、帝王切開による出産は、母体の共生細菌の伝播が阻害されることと環境的起源を持つ可能性の高い薬剤耐性日和見病原体の定着が多いことと関連することが明らかになった。帝王切開によって生まれた乳児の約83%が疾患発症の原因となる可能性がある細菌を持っていたのに対し、経腟分娩で生まれた乳児の場合は約49%だった。また、経腟分娩児の腸微生物相の組成の変動の最大の原因は、母親の抗生物質使用だった。


Babies delivered by caesarean section tend to have altered gut microbiota and are more prone to colonization by bacteria that potentially cause disease, according to a report in Nature. In the largest known study of its kind, the results confirm previous findings suggesting that the mode of delivery is a major factor that shapes the gut microbiota in the first few weeks of life.

Newborn babies acquire microorganisms from their mothers and surrounding environment that seed their gut microbiota; disruption of this process has been associated with the development of some diseases in childhood or later in life. Previous attempts to understand what influences the composition of the gut microbiota in babies during the first month of life (the neonatal period) have been limited by small sample sizes and poor resolution of the microbiota.

Trevor Lawley and colleagues performed whole-genome sequencing of the human gut microbiota in 596 full-term babies born in UK hospitals to determine how birth by caesarean section shapes the composition of the microbiota during the neonatal period. Of the babies studied, there were 314 vaginal births and 282 were delivered via caesarean section. The analyses revealed that delivery by caesarean section was associated with disrupted transmission of maternal commensal bacteria and a higher incidence of colonization with drug-resistant opportunistic pathogens, which are likely to be of environmental origin. Around 83% of babies delivered by caesarean section were found to carry potentially pathogenic bacteria, compared with around 49% of the vaginally delivered babies. Maternal antibiotic use accounted for the greatest amount of variation in the composition of gut microbiota in vaginally delivered babies.

The clinical consequences of disruptions to gut microbiota and presence of pathogens in early life remain to be determined, the authors conclude.

doi: 10.1038/s41586-019-1560-1

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