scholarly journals Association of Cesarean Delivery and Formula Supplementation with the Stool Metabolome of 6-Week-Old Infants

Metabolites ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 702
Author(s):  
Anne G. Hoen ◽  
Modupe O. Coker ◽  
Juliette C. Madan ◽  
Wimal Pathmasiri ◽  
Susan McRitchie ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Metabolic Pathways ◽  
Metabolic Response ◽  
Delivery Mode ◽  
Feeding Method ◽  
Feeding Groups ◽  
Factors Associated ◽  
Feeding Type ◽  
Infant Gut Microbiome ◽  
Breast Fed

Cesarean delivery and formula feeding have both been implicated as important factors associated with perturbations to the infant gut microbiome. To investigate the functional metabolic response of the infant gut microbial milieu to these factors, we profiled the stool metabolomes of 121 infants from a US pregnancy cohort study at approximately 6 weeks of life and evaluated associations with delivery mode and feeding method. Multivariate analysis of six-week stool metabolomic profiles indicated discrimination by both delivery mode and diet. For diet, exclusively breast-fed infants exhibited metabolomic profiles that were distinct from both exclusively formula-fed and combination-fed infants, which were relatively more similar to each other in metabolomic profile. We also identified individual metabolites that were important for differentiating delivery mode groups and feeding groups and metabolic pathways related to delivery mode and feeding type. We conclude based on previous work and this current study that the microbial communities colonizing the gastrointestinal tracts of infants are not only taxonomically, but also functionally distinct when compared according to delivery mode and feeding groups. Further, different sets of metabolites and metabolic pathways define delivery mode and diet metabotypes.

scholarly journals The effect of 2′-fucosyllactose on simulated infant gut microbiome and metabolites; a pilot study in comparison to GOS and lactose

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Krista Salli ◽  
Heli Anglenius ◽  
Johanna Hirvonen ◽  
Ashley A. Hibberd ◽  
Ilmari Ahonen ◽  
...  
Keyword(s):  
Energy Source ◽  
Lactic Acid ◽  
Faecal Sample ◽  
Short Chain Fatty Acids ◽  
Feeding Type ◽  
Source Data ◽  
Infant Gut Microbiome ◽  
And Control ◽  
Breast Fed ◽  
Additional Carbon Source

Abstract Human milk oligosaccharides (HMOs) shape gut microbiota during infancy by acting as fermentable energy source. Using a semi-continuous colon simulator, effect of an HMO, 2′-fucosyllactose (2′-FL), on composition of the infant microbiota and microbial metabolites was evaluated in comparison to galacto-oligosaccharide (GOS) and lactose and control without additional carbon source. Data was analysed according to faecal sample donor feeding type: breast-fed (BF) or formula-fed (FF), and to rate of 2′-FL fermentation: fast or slow. Variation was found between the simulations in the ability to utilise 2′-FL. The predominant phyla regulated by 2′-FL, GOS and lactose were significant increase in Firmicutes, numerical in Actinobacteria, and numerical decrease in Proteobacteria compared to control. Verrucomicrobia increased in FF accounted for Akkermansia, whereas in fast-fermenting simulations Actinobacteria increased with trend for higher Bifidobacterium, and Proteobacteria decrease accounted for Enterobacteriaceae. Short-chain fatty acids and lactic acid with 2′-FL were produced in intermediate levels being between ones generated by the control and GOS or lactose. In 2′-FL fast-fermenting group, acetic acid specifically increased with 2′-FL, whereas lactose and GOS also increased lactic acid. The results highlight specificity of 2′-FL as energy source for only certain microbes over GOS and lactose in the simulated gut model.

scholarly journals Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana

2014 ◽  
Vol 18 (4) ◽  
pp. 669-678 ◽  
Author(s):  
Abukari I Issaka ◽  
Kingsley E Agho ◽  
Penelope Burns ◽  
Andrew Page ◽  
Michael J Dibley
Keyword(s):  
Risk Factors ◽  
Health Survey ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Demographic And Health Survey ◽  
Meal Frequency ◽  
Factors Associated ◽  
Minimum Dietary Diversity ◽  
Breast Fed

AbstractObjectiveTo explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey.DesignThe source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling.SettingGhana.SubjectsChildren (n 822) aged 6–23 months.ResultsThe prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6–8 months was 72·6 % (95 % CI 64·6 %, 79·3 %). The proportion of children aged 6–23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46·0 % (95 % CI 42·3 %, 49·9 %) and 51·4 % (95 % CI 47·4 %, 55·3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29·9 % (95 % CI 26·1 %, 34·1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3·55; 95 % CI 1·05, 12·02).ConclusionsThe prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

scholarly journals The association of interpregnancy interval and mode of delivery with outcomes among a cohort of Guatemalan women with a history of prior cesarean

2020 ◽  
Author(s):  
Margo Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Delivery Mode ◽  
Interpregnancy Interval ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Birth ◽  
Dilation And Curettage ◽  
History Of ◽  
Repeat Cesarean Delivery

Abstract Design: Our objectives were to analyze how interpregnancy interval (IPI) was associated with delivery mode and how outcomes varied by these characteristics.Methods: This secondary analysis used data from a prospective study conducted in Chimaltenango, Guatemala from January 2017 through April 2020.Results: Of 26,465 Guatemalan women, 3,170 (12.0%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean delivery. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI (AOR 0.01 – 0.03, p < 0.001). Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR 0.009 – 0.10, p < 0.001), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2, p = 0.001 – 0.002), but again IPI was not associated with the outcome.Conclusion: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.

scholarly journals Is there any difference between the iodine statuses of breast-fed and formula-fed infants and their mothers in an area with iodine sufficiency?

2018 ◽  
Vol 119 (9) ◽  
pp. 1012-1018 ◽  
Author(s):  
Pantea Nazeri ◽  
Hosein Dalili ◽  
Yadollah Mehrabi ◽  
Mehdi Hedayati ◽  
Parvin Mirmiran ◽  
...  
Keyword(s):  
Breast Milk ◽  
Breast Feeding ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Formula Feeding ◽  
Exclusive Breast Feeding ◽  
Feeding Group ◽  
Feeding Type ◽  
Breast Fed ◽  
Iodine Sufficiency

AbstractDespite substantial progress in the global elimination of iodine deficiency, lactating mothers and their infants remain susceptible to insufficient iodine intake. This cross-sectional study was conducted to compare iodine statuses of breast-fed and formula-fed infants and their mothers at four randomly selected health care centres in Tehran. Healthy infants <3 months old and their mothers were randomly selected for inclusion in this study. Iodine was measured in urine and breast milk samples from each infant and mother as well as commercially available infant formula. The study included 124 postpartum mothers (29·2 (sd 4·9) years old) and their infants (2·0 (sd 0·23) months old). The iodine concentrations were 50–184 µg/l for infant formula, compared with a median breast milk iodine concentration (BMIC) of 100 µg/l in the exclusive breast-feeding group and 122 µg/l in the partial formula feeding group. The median values for urinary iodine concentration in the exclusive breast-feeding group were 183 µg/l (interquartile range (IQR) 76–285) for infants and 78 µg/l (IQR 42–145) for mothers, compared with 140 µg/l (IQR 68–290) for infants and 87 µg/l (IQR 44–159) for mothers in the formula feeding group. These differences were not statistically significant. After adjustment for BMIC, ANCOVA revealed that feeding type (exclusive breast-feeding v. partial formula feeding) did not significantly affect the infants’ or mother’s urinary iodine levels. Thus, in an area with iodine sufficiency, there was no difference in the iodine statuses of infants and mothers according to their feeding type.

Adverse Events and Factors Associated with Potentially Avoidable Use of General Anesthesia in Cesarean Deliveries

2019 ◽  
Vol 130 (6) ◽  
pp. 912-922 ◽  
Author(s):  
Jean Guglielminotti ◽  
Ruth Landau ◽  
Guohua Li
Keyword(s):  
Adverse Events ◽  
General Anesthesia ◽  
Cesarean Delivery ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neuraxial Anesthesia ◽  
General Anesthetics ◽  
Factors Associated ◽  
Increased Risk ◽  
Anesthesia Complications

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. Methods This retrospective study analyzed cesarean delivery cases without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia in New York State hospitals, 2003 to 2014. Adverse events included anesthesia complications (systemic, neuraxial-related, and drug-related), surgical site infection, venous thromboembolism, and the composite of death or cardiac arrest. Anesthesia complications were defined as severe if associated with death, organ failure, or prolonged hospital stay. Results During the study period, 466,014 cesarean deliveries without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia were analyzed; 26,431 were completed with general anesthesia (5.7%). The proportion of avoidable general anesthetics decreased from 5.6% in 2003 to 2004 to 4.8% in 2013 to 2014 (14% reduction; P &lt; 0.001). Avoidable general anesthetics were associated with significantly increased risk of anesthesia complications (adjusted odds ratio, 1.6; 95% CI, 1.4 to 1.9), severe complications (adjusted odds ratio, 2.9; 95% CI, 1.6 to 5.2), surgical site infection (adjusted odds ratio, 1.7; 95% CI, 1.5 to 2.1), and venous thromboembolism (adjusted odds ratio, 1.9; 95% CI, 1.3 to 3.0), but not of death or cardiac arrest. Labor neuraxial analgesia rate was one of the most actionable hospital-level factors associated with avoidable general anesthetics. Relative to hospitals with a rate greater than or equal to 75%, the adjusted odds ratio of avoidable general anesthetics increased to 1.3 (95% CI, 1.2 to 1.4), 1.6 (95% CI, 1.5 to 1.7), and 3.2 (95% CI, 3.0 to 3.5) as the rate decreased to 50 to 74.9%, 25 to 49.9%, and less than 25%, respectively. Conclusions Compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.

Lumbar Sympathetic Blocks Speed Early and Second Stage Induced Labor in Nulliparous Women 

1999 ◽  
Vol 90 (4) ◽  
pp. 1039-1046 ◽  
Author(s):  
Barbara L. Leighton ◽  
Stephen H. Halpern ◽  
Donna B. Wilson
Keyword(s):  
Epidural Analgesia ◽  
Cesarean Delivery ◽  
Delivery Mode ◽  
Sympathetic Block ◽  
Cervical Dilation ◽  
Induced Labor ◽  
Second Stage ◽  
Vaginal Deliveries ◽  
Epidural Catheters ◽  
Sympathetic Blocks

Background Rapid cervical dilation reportedly accompanies lumbar sympathetic blockade, whereas epidural analgesia is associated with slow labor. The authors compared the effects of initial lumbar sympathetic block with those of epidural analgesia on labor speed and delivery mode in this pilot study. Methods At a hospital not practicing active labor management, full-term nulliparous patients whose labors were induced randomly received initial lumbar sympathetic block or epidural analgesia. The latter patients received 10 ml bupivacaine, 0.125%; 50 microg fentanyl; and 100 microg epinephrine epidurally and sham lumbar sympathetic blocks. Patients to have lumbar sympathetic blocks received 10 ml bupivacaine, 0.5%; 25 microg fentanyl; and 50 microg epinephrine bilaterally and epidural catheters. Subsequently, all patients received epidural analgesia. Results Cervical dilation occurred more quickly (57 vs. 120 min/cm cervical dilation; P = 0.05) during the first 2 h of analgesia in patients having lumbar sympathetic blocks (n = 17) than in patients having epidurals (n = 19). The second stage of labor was briefer in patients having lumbar sympathetic blocks than in those having epidurals (105 vs. 270 min; P &lt; 0.05). Nine patients having lumbar sympathetic block and seven having epidurals delivered spontaneously, whereas seven patients having lumbar sympathetic block and seven having epidurals had instrument-assisted vaginal deliveries. Cesarean delivery for fetal bradycardia occurred in one patient having lumbar sympathetic block. Cesarean delivery for dystocia occurred in five patients having epidurals compared with no patient having lumbar sympathetic block (P = not significant). Visual analog pain scores differed only at 60 min after block. Conclusions Nulliparous parturients having induced labor and receiving initial lumbar sympathetic blocks had faster cervical dilation during the first 2 h of analgesia, shorter second-stage labors, and a trend toward a lower dystocia cesarean delivery rate than did patients having epidural analgesia. The effects of lumbar sympathetic block on labor need to be determined in other patient groups. These results may help define the tocodynamic effects of regional labor analgesia.

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