Assessing multiple factors affecting the gut microbiome structure of very preterm infants

The composition and diversity of the gut microbiota are essential for the health and development of the immune system of infants. However, there is limited information on factors that influence the gut microbiota of very preterm infants. In this study, we analyzed factors that affect the gut microbiota of very preterm infants. The stool samples from 64 very preterm infants with a gestational age less than 32 weeks were collected for 16S rRNA gene sequencing. The infants were divided according to the delivery mode, antibiotic use during pregnancy, and feeding methods. The abundance of Proteobacteria was high in both cesarean (92.7%) and spontaneous (55.5%) delivery groups and then shifted to Firmicutes after the first week of birth. In addition, Proteobacteria was also the dominant phylum of infant gut microbiome for mothers with antibiotic use, with more than 50% after the first week of birth. In comparison, the dominant phylum for mothers without antibiotic use was Firmicutes. Proteobacteria level was also high in breastfeeding and mixed-feeding groups, consisting of more than 90% of the community. By contrast, Proteobacteria was the dominant phylum at the first week of birth but then shifted to Firmicutes for the formula-fed group. The alterations of gut microbiota in infants can affect their health condition during growth. This study confirmed that the different feeding types, delivery modes, and use of antibiotics during pregnancy can significantly affect the composition of the gut microbiota of very preterm infants.

Effects of delivery and feeding modes on intestinal microflora in infants with atopic dermatitis / 中华皮肤科杂志

Objective:To investigate the effect of different delivery and feeding modes on intestinal microflora in infants with atopic dermatitis (AD) .Methods:A total of 33 infants with AD were enrolled from Department of Dermatology, Wuhan NO.1 Hospital from July 2019 to December 2020, and 30 healthy infants were selected as control group. Then, all infants were grouped according to different delivery and feeding modes: cesarean-delivery AD group (22 cases) , cesarean-delivery control group (19 cases) , spontaneous-delivery AD group (11 cases) , and spontaneous-delivery control group (11 cases) ; mixed-feeding AD group (13 cases) , mixed-feeding control group (11 cases) , formula milk powder-feeding AD group (12 cases) , formula milk powder-feeding control group (11 cases) , breastfeeding AD group (8 cases) , and breastfeeding control group (12 cases) . The total DNA was extracted from the infant feces, PCR was performed to amplify the V1 - V9 regions of bacterial 16S rRNA gene, and PacBio Sequel sequencer was used for high-throughput sequencing. Wilcoxon rank sum test was used to compare the bacterial community composition at genus and species levels, and correlations of relative abundance of differentially abundant bacterial taxa with eosinophil counts and SCORing Atopic Dermatitis (SCORAD) scores were analyzed.Results:In the spontaneous-delivery control group, cesarean-delivery control group, spontaneous-delivery AD group, and cesarean-delivery AD group, the top 5 bacterial genera with high relative abundance were Bifidobacterium, Bacteroides, Veillonella, Streptococcus, and Escherichia. In the formula milk powder-feeding control group, breastfeeding control group, mixed-feeding control group, formula milk powder-feeding AD group, breastfeeding AD group, and mixed-feeding AD group, the top 5 abundant bacterial genera were Bifidobacterium, Bacteroides, Clostridium, Veillonella, and Escherichia. Linear discriminant analysis of effect size (LEfSe) showed no significant difference in the relative abundance of bacterial taxa among different delivery mode groups; among different feeding mode groups, Akkermansia and Akkermansiamuciniphila were the most differentially abundant microbes in the formula milk powder-feeding AD group at genus (LDA = 4.78) and species (LDA = 4.91) levels, respectively. The relative abundance of Akkermansia and Akkermansiamuciniphila (both 9.6% ± 0.72%) was significantly higher in the formula milk powder-feeding AD group than in the formula milk powder-feeding control group (both 2.50% ± 0.83%, Z = 1.66, P = 0.048) , the mixed-feeding AD group (both 0, Z = 2.26, P = 0.012) and the breastfeeding AD group (both 0, Z = 1.85, P = 0.032) . Additionally, the relative abundance of Akkermansia and Akkermansia- muciniphila was positively correlated with SCORAD scores in AD patients ( ρ = 0.384, 0.387, respectively, both P < 0.05) . Conclusion:Different delivery modes did not significantly affect the intestinal flora of AD or healthy infants, and the relative abundance of Akkermansia and Akkermansiamuciniphila increased in the formula milk powder-feeding infants with AD, which may be involved in the occurrence of AD.

Childhood emotional and behavior problems and their associations with cesarean delivery

Objective: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. Methods: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. Results: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). Conclusion: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.

Early-life dynamics of the human intestinal microflora and related influencing factors / 中华临床营养杂志

The intestinal microflora in early life mainly comes from the exchange of bacteria between the mother and the newborn.From birth to childhood,intestinal microflora undergoes a dynamic change.An increasing number of studies have shown that mode of delivery and feeding as well as the use of antibiotics during pregnancy are the main influencing factors of intestinal microflora in early life.However,the specific mechanisms have yet to be fully understood.This article reviews the dynamics of intestinal microflora in early life and the related influencing factors.

The delivery methods for second birth and influencing factors in Xinjiang / 现代临床护理

Objective To investigate the willingness of delivery methods for second birt hand the actual delivery methods and analyze the influencing factors. Method The random cluster sampling method was adopted to randomly collect 1,237 women who delivered secondly or took antenatal care in two hospitals between October 2016 and April 2017,surveying their willingness of delivery methods for second birt hand the actual delivery methods.Results In the final delivery method,688 cases (54.62%)chose natural childbirth and 549 (45.38%)caesarean section. Logistic regression analysis showed age, nationality, first child delive mode, related knowledge of childbirth,and willingness to give birth were the main factors influencing the method of maternal delivery(all P<0.05). Conclusions The rate of caesarean section is higher for the second-child pregnant women.Individual willing is the most important factor influencing the selection of delivery methods.Therefore,we should enhance the education on the childbirth knowledge to the mothers and their families,helping them to make reasonable choices of delivery methods,for the purpose of reducing the rate of dissection.

Effect of different cervical treatment on pregnancy outcome and delivery mode / 重庆医学

Objective To explore the pregnancy outcome and delivery method after different cervical treatment.Methods A total of 249 primipara (research group)following the different cervical treatment before pregnancy were divided into operative group (97 cases)and physiotherapy group (152 cases)according to the type of cervical treatment.250 primipara (control group) of the same period had not undergone the cervical treatment.All patients were delivered in maternal and child health care hospital of H ubei province from June 2012 to June 2015.The rates of cesarean section,the preterm delivery,premature rupture of membranes,the duration of labor,neonatal weight were compared between the groups.Resnlts (1) In the research group,the rates of cesarean section (65.86％),the risk of the preterm delivery(13.65 ％),premature rupture of membranes(20.48 ％),were significantly higher than control group(x2 =18.428,10.452,8.066,P＜0.01).The neonatal weight of research group (3 360.714-517.08)g was lower in comparison with that of control group(x2=2.459,P＜0.05).(2)The rates of cesarean section of operative group and physiotherapy group was 76.28％ and 59.21％ (P＜0.05).The premature rupture of membranes 28.87％ and 15.13％ in each group (P＜0.05).(3) The labor duration of operative group (7.18 ± 2.97) h,physiotherapy group(7.27-4-3.17) h.and control group (7.71±2.88)h has no significant difference (x2 =0.915,0.790,0.143,P＞0.05).Conclusion cervical treatment increases the rates of cesarean section,the risk of preterm delivery and premature rupture of membranes.But there was no effect on the duration labor of various types of cervical treatment.

Clinic research on delivery mode selection of re-pregnancy after cesarean delivery / 中国基层医药

Objective To discuss the main reason of re -pregnant patients'delivery mode selection after cesarean delivery and to guide the future clinical work.Methods Retrospectively analyzed the 181 cases of re -pregnancy after cesarean delivery and compare the clinical data of 140 cases of reselecting cesarean delivery with 41 cases of selecting vaginal trial production.Results Calculated the risks of vaginal trial production and cesarean delivery of scarred uterus by Smith formula.There was no statistically significant difference in two groups (P >0.05). Reselection of cesarean delivery accounted for 77.0% among the cases of re -pregnancy after cesarean delivery.In the investigation on the reason for re -pregnant patients reselecting cesarean delivery,38 patients chose cesarean delivery for the first time owing to social factors,accounted for 27.1%,taking the first place.While in the investiga-tion on the reason for re -pregnant patients selecting vaginal trial production,10 patients were operated on cesarean section for the first time due to fetal distress,accounted for 24.4%,coming first.Conclusion In the investigation on the reason for re -pregnant patients reselecting cesarean delivery,the result shows that the high possibility of reselect-ing cesarean delivery lies on those who chose cesarean delivery for the first time owing to social factors.While those who were transferred to cesarean section due to abnormal fetal heart rate during the first vaginal trial production,may have high possibility to select vaginal trial production when re -pregnancy.As a result,the key is to decrease the rate of cesarean delivery for the first time.

Selection of modes of delivery in the oligohydramnios patients / 中国综合临床

Objective To explore the prognosis of children under different modes of delivery in the oli?gohydramnios patients,in order to reduce unnecessary cesarean section rate. Methods One hundred and forty?eight cases of oligohydramnios from September 2013 to October 2015 in the First Affiliated Hospital of Tsinghua University were reviewed,including 74 cases of vaginal delivery,54 cases of vaginal delivery group,20 cases for fetal heart abnormalities in the induction of labor or labor in the process or abortion failure emergency caesarean birth operation( pilot transfer of emergency cesarean section delivery group);direct line selective cesarean section in 74 cases. The delivery surround unripe ending of three kinds of delivery mode was compared,and gestational weeks,estate, cervical score, maximal amniotic fluid dark area vertical depth ( AFV), amniotic fluid index ( AFI) ,fetal size,water treatment and abortion case of the vaginal delivery and emergency caesarean birth were statistically compared. Results Both fetal heart abnormality and amniotic fluid of third degree incidence of trial production of emergency cesarean section group was 80. 00%( 16/20) ,of vaginal delivery group was respectively 11. 11%( 6/54) ,29. 63 ( 16/54) ,and of selective cesarean section delivery group was 0 and 9. 50%( 7/74) re?spectively,the difference between the 3 groups was statistically significant( P2 cm,the high rate of abortion sensi?tive pregnant women with high rate of vaginal delivery.

Investigation on the repeat pregnant women′s knowledge of delivery mode after cesarean section / 中国实用护理杂志

Objective To study the repeat pregnant women′s awareness level of delivery mode knowledge after cesarean section, in order to provide a basis for making effective intervention programs and reduce the cesarean delivery on maternal request rate. Methods Investigated on the knowledge of delivery mode after cesarean section for 330 repeat pregnant women on Maternal and Children Healthy Hospital of Shanxi Province by questionnaire. Results This study investigated 330 repeat pregnant women, recycling effective questionnaire 318, and the recycling effective rate was 96.4%. Different pregnant women with different education level, the number of weeks of gestation, the doctors′recommendations on the delivery had different scores of knowledge of delivery mode after cesarean section. The difference was significant (P < 0.05). The Multi-factor Logistics regression analysis showed that the repeat pregnant women′ s education and the doctors′recommendations on the delivery are associated with the scores of knowledge of delivery mode after cesarean section (P<0.05). The more higher level of their education, and if the doctor had provided the advice of delivery mode to repeat pregnant women before, the more higher scores the repeat pregnant women got. Conclusions The level of the knowledge of delivery mode after cesarean section is low. It′s time to take appropriate health education intervention strategies to reduce the rate of cesarean delivery on maternal request.

Evaluating the short-term effect of delivery mode on female anterior compartment of pelvic floor / 中华超声影像学杂志

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional 2D ultrasound and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks The position of bladder the existence of bladder neck funneling were observed and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver The rates of bladder neck funneling cystocele and stress urinary incontinence were higher in vaginal delivery group Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery.

Dynamics of Gut Microbiota According to the Delivery Mode in Healthy Korean Infants

Microbial colonization of the infant gut is unstable and shows a wide range of diversity between individuals. Gut microbiota play an important role in the development of the immune system, and an imbalance in these organisms can affect health, including an increased risk of allergic diseases. Microbial colonization of young infants is affected by the delivery mode at birth and the consequent alterations of gut microbiota in early life affect the development of allergic diseases. We investigated the effects of the delivery mode on the temporal dynamics of gut microbiota in healthy Korean infants. Fecal samples were collected at 1-3 days, 1 month, and 6 months after birth in six healthy infants. Microbiota were characterized by 16S rRNA shotgun sequencing. At the first and third days of life, infants born by vaginal delivery showed a higher richness and diversity of gut microbiota compared with those born by cesarean section. However, these differences disappeared with age. The Bacteroides genus and Bacteroidetes phylum were abundant in infants born by vaginal delivery, whereas Bacilli and Clostridium g4 were increased in infants born by cesarean section. The Firmicutes phylum and Bacteroides genus showed convergent dynamics with age. This study demonstrated the effect of delivery mode on the dynamics of gut microbiota profiles in healthy Korean infants.

The significance of ultrasound in helping 200 cases scarred uterus gravidas chosing their second delivery modes / 重庆医学

Objective To explore the significance of ultrasound in choosing the delivery modality in 200 cases scarred uterus gravida′s second deliveries .Methods The study selected 200 cases late pregnancy gravidas who had once uterine incision delivery history and analyzed clinical data retrospectively ,all of them were chosen from September 2010 to September 2013 in our hospital . All cases were taken by transabdominal ultrasound or transvaginal ultrasound firstly ,then taken by transabdomina transvaginal ul‐trasound ,finally contrast obsenved the transabdomina transvaginal ultrasound detections with their caesarean section observations , meanwhile observe how the uterus scar ranking affect the delivery consequence .Results (1)A total of 200 cases had higher uterus scars visualization ratio(100 .0% ) than ransabdominal ultrasound (92 .0% )and transvaginal ultrasound(96 .5% )(P0 .05) .The grading diagnosis coincidence of transabdomina‐transvaginal ultrasound was 89 .74% .(2)The UD rate ,the bleeding vol‐ume during operation and the 24 hours postoperative bleeding volume of scarred uterus gravida grade Ⅱ and grade Ⅲ were signifi‐cantly higher than grade Ⅰ (P<0 .05) .Conclusion Transabdomina transvaginal ultrasound can effectively improve the diagnosis coincidence rate of uterine scar detection and can help to chose the better delivery mode according to the scars healing .

The explore of mode of delivery and pregnancy outcomes in prolonged pregnancy / 中国医师进修杂志

Objective To investigate the relationship between prolonged pregnancy,mode of delivery and pregnancy outcomes.Methods A retrospective analysis of the January 2009 to November 2012,406 cases of prolonged pregnancy cases.Results Select meconium staining of the vaginal trial production of transit emergency caesarean section and vaginal delivery group,the incidence of neonatal asphyxia significantly higher than the cesarean group (P＜0.05).Conclusion The prolonged pregnancy conditional vaginal delivery should be closely monitoring fetal heart rate,timing line CST monitoring patients,cervical score the first basin ratings,observation of amniotic fluid nature and progress of labor,and timely cesarean important treatment prolonged pregnancy safety measures.

Effect of the family-centered prenatal maternal health education on delivery methods and breast feeding / 现代临床护理

Objective To explore the effect of the family-centered prenatal maternal health education on delivery modes and breastfeeding.Methods Two hundred and thirty pregnant women who accepted prenatal maternal health education were divided into the observation group and the control group according to whether their families involved in the prenatal education.There were 108 cases in the observation group and 122 in the control group.The observation group was given prenatal health education involving the pregnant women and their caregivers or their husbands.The control group was given prenatal health education according to the previously-designed course without presence of their families.The two groups were compared in delivery mode,extent of pain during production and breast feeding.Results The rates of vaginal delivery and the breast feeding at discharge in the observation group were higher than the control group(P<0.05 for both).The rate of breast swelling in 72 hours was significantly lower than the control group(P<0.01). Conclusion Family-centered prenatal maternmal health education is good for the natural birth rate,improvement of breastfeeding rate and reduction the breast swelling.

Related factor analysis of prenatal anxiety and its relationship with delivery mode of primiparae / 中国实用护理杂志

Objective To investigate the prenatal emotional disorder of the primipame and the related factors,and to analyze its influence on the delivery mode.Methods In the prospective cohort study,590 healthy primiparase were asked to complete a self-compiled questionnaires for their general social mental state,state-trait anxiety inventory(STAI)and self-rating depression scale(SDS).Results Questionnaires of 159 patients were selected and these patients were divided into the anxiety group(114 cases)and the control group(455 cases),the depression group(159 cases)and the control group(410 cases).The ratio of selective cesarean section in the anxiety group was significantly higher(45.61%,32.53%,X2=6.85,P＜0.01),while the successful trial of labor were less than that of the control group(19.35%,47.88%,X2=26.30,P＜0.01).The ratio of selective cesarean section in the depression group was significandy higher than that of the control group(46.54%,31.95%,X2=10.21,P＜0.01),while the successful trial of labor were less than that of the control group(31.76%.46.59%,X2=9.13,P＜0.01).Single-factor analysis showed that prenatal anxiety related to the following factors:fear of childbirth,worried about their children,knowledge for childbirth,high economic status,maternal age and their own economic situation.Conclusions Higher incidence and risk factors of anxiety or depression before delivery,such as advanced delivery age,bad economic condition,weak family support,worrying about the safety of babies and themselves,are found in our study.Prenatal emotional disorder would affect the quality of labor and delivery options,and lead the high risk of cesarean section.

Blood Pressure of Healthy Newborns in the First Week of Life

PURPOSE: This study was performed to study normative blood pressure data in full-term neonates that may be used to facilitate identification of neonatal hypertension. METHODS: 383 newborns born in our hospital from May 2003 to January 2004 were enrolled in this study. Using an oscillometric device(BP-88 NEXT, COLIN Corp.), their blood pressures were measured more than one time within a week after birth. According to each clinical variable such as sex, delivery mode, birth weight, gestational age and presence of maternal disease or perinatal problems, we divided the population into groups and calculated the mean blood pressures of each group. We compared mean blood pressures between the divided groups according to each clinical variable statistically. RESULTS: Mean systolic and diastolic blood pressure of the population was 70.8+/-10.9 mmHg and 43.4+/-8.0 mmHg, respectively. There was no statistically significant difference in blood pressure according to clinical variables. Mean systolic pressure showed positive correlation with birth weight and gestational age(r=0.1420, 0.0360). CONCLUSION: Our results are almost in agreement with Zubrow's data from 695 newborns in U.S.A, 1995. Our data may be helpful for early detection and management of neonatal hypertension, thereby maintaining renal function and preventing possible complications of renal disease.

Fetal Macrosomia (> or = 4,500 g): A Clinical Study of 271 Cases according to the Mode of Delivery / 대한주산의학회잡지

OBJECTIVE: To determine obstetric outcome in infants > or =4,500 g according to delivery mode. METHODS: Records of 271 mothers and infants weighing > or =4,500 g over a 11-year period (1993~2003) were retrospectively reviewed. Maternal and perinatal outcomes were compared in relation to delivery mode. RESULTS: The frequency of macrosomia ranged 0.38% in 4,500 g or more. Vaginal delivery was achievable in 78/271 (28.8%) of women allowed to labor, of which 71.2% were operative. In macrosomia frequency correlations to parity showed 33.9% (92 cases) in primiparous women, 66.9% (179 cases) in multiparous women. According to the type of delivery, cesarean section has proven to be the most popular mode. The cesarean section group had a higher incidence of maternal BMI (> 25 kg/m2). The frequency of diabetes, hypertension, low Apgar score at 5 and 10 minutes was similar in both groups. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Maternal height, weight, BMI (body mass index) may associated with fetal body weight and delivery mode.