Research ArticleGUT MICROBIOTA

Delivery mode and gut microbial changes correlate with an increased risk of childhood asthma

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Science Translational Medicine  11 Nov 2020:
Vol. 12, Issue 569, eaax9929
DOI: 10.1126/scitranslmed.aax9929

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Connecting the dots

Children born by cesarean section have an increased risk of developing asthma compared to children born by vaginal delivery and also have an altered gut microbiota composition. Stokholm et al. now report that these factors are linked. They found an increased risk of asthma in children born by cesarean section if their gut microbiota profile at 1 year of age remained similar to that at birth. No association with asthma risk was found with gut microbiota perturbations that occurred at birth but resolved by 1 year of age. This suggests that healthy maturation of the gut microbiota may decrease the risk of developing asthma for children born by cesarean section.


There have been reports of associations between cesarean section delivery and the risk of childhood asthma, potentially mediated through changes in the gut microbiota. We followed 700 children in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort prospectively from birth. We examined the effects of cesarean section delivery on gut microbial composition by 16S rRNA gene amplicon sequencing during the first year of life. We then explored whether gut microbial perturbations due to delivery mode were associated with a risk of developing asthma in the first 6 years of life. Delivery by cesarean section was accompanied by marked changes in gut microbiota composition at one week and one month of age, but by one year of age only minor differences persisted compared to vaginal delivery. Increased asthma risk was found in children born by cesarean section only if their gut microbiota composition at 1 year of age still retained a cesarean section microbial signature, suggesting that appropriate maturation of the gut microbiota could mitigate against the increased asthma risk associated with gut microbial changes due to cesarean section delivery.

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