Cesarean section changes neonatal gut colonization

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Cesarean section changes neonatal gut colonization Jakob Stokholm, MD, PhD, Jonathan Thorsen, MD, Bo L. Chawes, MD, PhD, Susanne Schjørring, MSc, PhD, Karen A. Krogfelt, MSc, PhD, Klaus Bønnelykke, MD, PhD, Hans Bisgaard, MD, DMSc Journal of Allergy and Clinical Immunology Volume 138, Issue 3, Pages 881-889.e2 (September 2016) DOI: 10.1016/j.jaci.2016.01.028 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Associations between delivery by means of cesarean section and fecal colonization at age 1 week (A), 1 month (B), and 1 year (C). A cutoff value of greater than 2% of children colonized was used for a species to be represented in the analyses. All analyses were adjusted for gestational age, parity, hospitalization, and duration of exclusive breast-feeding. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Cultured fecal species compared by delivery method and development over time. Percentages of colonized children at age 1 week, 1 month, and 1 year are shown and grouped by delivery method: natural (solid lines), emergency cesarean section (dotted lines), and elective cesarean section (dashed lines). Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Associations between delivery by means of cesarean section and hypopharyngeal colonization at age 1 week (A), 1 month (B), and 3 months (C). A cutoff value of greater than 2% of children colonized was used for a species to be represented in the analyses. All analyses were adjusted for gestational age, parity, hospitalization, and duration of exclusive breast-feeding. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Three-way PLS model describing fecal colonization patterns and time differences for all participants. A, Score plot: each point corresponds to 1 child, and colors indicate type of delivery method. B, Pattern mean score of LV1 over time for children born by means of cesarean section and natural delivery. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Score plot from PLS model on fecal colonization at age 1 week. Each point corresponds to 1 child, and colors indicate type of delivery method. The distribution of the specific delivery method is shown as ellipses with coverage of 1 SD in 2 dimensions. LV1 explains 5.9% and LV2 explains 3.7% of total variation in bacterial colonization. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Associations between delivery by means of cesarean section and fecal colonization at age 1 week stratified for intrapartum antibiotics. A cutoff value of greater than 2% of children colonized was used for a species to be represented in the analyses. All analyses were adjusted for gestational age, parity, hospitalization, and duration of exclusive breast-feeding. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Associations between intrapartum antibiotics and fecal colonization at age 1 week stratified for natural delivery. A cutoff value of greater than 2% of children colonized was used for a species to be represented in the analyses. All analyses were adjusted for gestational age, parity, hospitalization, and duration of exclusive breast-feeding. Journal of Allergy and Clinical Immunology 2016 138, 881-889.e2DOI: (10.1016/j.jaci.2016.01.028) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions