This paper details a trial done to evaluate the effect of vaginal microbiota transfer (VMT) on the neurodevelopment and microbiome of caesarean born infants. It is believed that the microbiome plays an important role in immuno- and neurodevelopment of children in their early life. Caesarean section (c-section) though useful, influences the resulting microbiome of children as vaginal birth allows acquisition of different bacteria from the maternal birth canal such as Lactobacillus and Escherichia. C-section disrupted microbiomes have been proven to be associated with increased adverse health outcomes relating to neurodevelopmental, immune, and metabolic disorders.
To evaluate VMT a triple blinded randomised controlled trial was conducted. The final analysis involved sixty-eight pregnant women who were due to undergo c-section. These women were given gauze soaked with either vaginal fluids or normal saline (allocated blindly to a nurse via a third-party research member.) Thirty-three women scheduled for vaginal delivery were included as a reference group for VMT. The outcomes were assessed using a scoring system six months post birth called the ages and stages questionnaire for neurodevelopment (ASQ-3.) Infant faecal samples were also taken at days 3, 7, 30 and 42 to assess the gut microbiome.
Sampling was successfully done on the 32 women who received VMT and the 32 women who had saline (control group.) An analysis of adverse events was also done. In total there were 12.5% adverse events in those receiving VMT, compared to the vaginally delivered babies there was no significant difference suggesting that VMT is safe. The ASQ-3 questionnaire represents overall neurodevelopment. The total score at 6 months in the VMT group was significantly higher than that in the control group. Children in the VMT group had a very high communication and gross motor score specifically. The infant gut microbiome in the VMT group also had a significantly higher proportion of mother derived vaginal bacteria compared to the control group.
In conclusion it is thought that evidence from the trial proves that VMT may be able to restore the c-section induced gut microbiota. There also seems to be neurodevelopmental development enhancing metabolite pathways though it is unknown how gut metabolites effect the brain in this way. Ultimately it may be useful to investigate the exact mechanisms that mediate infant neurodevelopment and the gut microbiome. Additionally, the safety and efficacy of VMT may need more evaluation as this is a pilot study.
Zhou Lepeng, Qiu Wen, Wang Jie, et al. (2023) ‘Effects of vaginal microbiota transfer on the neurodevelopment and microbiome of cesarean-born infants: A blinded randomized controlled trial’, Available at: https://doi.org/10.1016/j.chom.