Trillions of microorganisms make up the human microbiome, which can be the key to improving health. Photo credit: NIH

Antibiotics for caesarean births are just as effective when given after umbilical cord entrapment as they are prior to entrapment – current practice – and, according to research co-authored by Rutgers, could benefit the developing microbiomes of newborns.

By far the largest of its kind, published in the journal Antimicrobial Resistance & Infection Control, questions current recommendations for the use of antibiotics. Administering antibiotics after clamping does not increase the risk of infection at the site of the caesarean sections, the study found.

“Most national and international guidelines, including the World Health Organization guidelines, recommend that women be given antibiotics before the skin incision for a cesarean section,” said co-author Maria Gloria Dominguez-Bello, Henry Rutgers Professor of Microbiome and Health, Professor of Microbiology and Anthropology and Director of the New Jersey Institute for Food, Nutrition and Health at the School of Environmental and Biological Sciences at Rutgers University-New Brunswick. “This exposes the baby to antibiotics during birth, which affects the microbiome assembly in the newborn. An early disruption of bacterial colonization and the developing healthy microbiome can have consequences for immune development and lead to immune system malfunctions later in life.”

A healthy microbiome protects against infection and antibiotics disrupt the microbiome and kill both bad and good bacteria, according to the U.S. Centers for Disease Control and Prevention. Even perceived stressors as small, like a hospital birth, can affect the newborn’s microbiome, as the Dominguez-Bello group showed in a 2018 study, and disruptions to the microbiome in early life can potentially affect immunity and metabolism development influence.

The administration of antibiotics to prevent infection of the surgical site is common practice and justified in order to minimize risks. However, a cesarean section should consider the effects of antibiotics on the newborn and its developing microbiome, as well as the risk of infection, Dominguez-Bello said. Giving antibiotics to mothers after clamping avoids additional stressors that interfere with the transmission and colonization of microbes in the mother after birth. Therefore, the current recommendation for antibiotics prior to clamping should be revised.

The study carried out by Rami Sommerstein at the University Hospital Bern in Switzerland comprised 55,901 women in 75 hospitals in Switzerland from 2009 to 2018. This included 26,405 patients given antibiotics before incisions for cesarean sections and 29,496 patients after their umbilical cords were clamped.

Of the 846 documented infections after caesarean sections, 379 (1.6 percent) occurred in women who received antibiotics before incisions and 449 (1.7 percent) in women who received antibiotics after their umbilical cords were clamped, with no statistical differences .

“That means taking antibiotics after the umbilical cords are trapped to protect the mother from infection is as effective as taking antibiotics before the incision,” said Dominguez-Bello. “The best time antibiotic use guidelines should be re-evaluated to encourage the development of a healthy microbiome, which is essential for normal development of the immune system in babies. Birth canal bypassing is already a stressor by the effect Shouldn’t be reinforced by antibiotics in the newborn. ”

It is safe to give antibiotics to mothers after the umbilical cord is pinched in a caesarean section to avoid exposure of newborns

More information:
Antibiotic Resistance and Infection Control,… 6 / s13756-020-00860-0 Provided by Rutgers University

Quote: Antibiotics for Caesarean sections that are effective after the umbilical cord has been pinched (2020, December 21), accessed on December 21, 2020 from umbilical-cord.html

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