Effect of Intrapartum Antibiotic Prophylaxis (IAP) on the Development of the Neonatal Gut Microbiota.
Status:
Completed
Trial end date:
2014-08-01
Target enrollment:
Participant gender:
Summary
The colonization of the neonatal gastro-intestinal (GI) tract begins at birth and is
influenced by several factors, such as mode of delivery, gestational age, maternal intestinal
and vaginal microbiota, type of feeding, hospitalization after birth and use of antibiotics
and probiotics.
Gut microbiota of term infants, vaginally delivered and exclusively breastfed, shows a low
count of C. difficile and E. coli and a high number of Bifidobacteria and Lactobacilli, which
positively influence the host's immunity processes; hence, is considered to be ideally
healthy.
Group B Streptococcus (GBS) represents one of the most important causes of neonatal
infections and sepsis. Infants vaginally delivered may acquire GBS during the birth process
from maternal vagina, cervix or rectum, where it resides in 10-20% of pregnant women. In the
last decade, the incidence of early-onset GBS sepsis is significantly reduced, due to the
introduction of GBS universal screening during late pregnancy and consequent intrapartum
antibiotic prophylaxis (IAP) in GBS-positive women.
The use of antibiotics in early life is shown to alter the commensal gut microbiota, thereby
impairing the balance between health and disease later in life. The effect of IAP on
bacterial colonization of the infant's gut, however, has not been largely investigated. The
investigators have previously evaluated the effect of IAP in a relatively small sample of
exclusively breast-fed term infants vaginally delivered by means of molecular techniques; at
7 days of life there were several differences in microbiota composition between infants
IAP-exposed and not exposed.
This observational prospective study thus aims to evaluate these differences in further
detail, expanding the initial sample to formula-fed term infants and following up infants
until one month of age. By including formula-fed infants, the investigators additionally aim
to evaluate the influence of feeding type on the neonatal microbiota composition.
Details
Lead Sponsor:
Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi IRCCS Azienda Ospedaliero-Universitaria di Bologna