Kulas Tomislav, Bursac Danijel, Zegarac Zana, Planinic-Rados Gordana, Hrgovic Zlatko
University Department of Gynecology and Obstetrics, Merkur University Hospital, Zagreb, Croatia.
Med Arch. 2013 Dec;67(6):460-3. doi: 10.5455/medarh.2013.67.460-463. Epub 2013 Dec 28.
Historical developments and advancements in cesarean section techniques and logistics have reduced the maternal and neonatal risks associated with the procedure, while increasing the number of operatively completed pregnancies for medically unjustifiable reasons. The uncritical attitude towards cesarean section and the fast emergence of 'modern' diseases such as obesity at a young age, asthma, type 1 diabetes mellitus and various forms of dermatitis have stimulated researches associating cesarean section with these diseases. Intestinal flora of the children born by cesarean section contains less bifidobacteria, i.e. their intestinal flora is similar to the intestinal flora in diabetic individuals. In children born by cesarean section, the 'good' maternal bacterial that are normally found in the maternal birth canal and rectum are lacking, while the 'bad' bacteria that may endanger the child's immune system are frequently present. In children born by vaginal delivery, the 'good' maternal bacteria stimulate the newborn's white blood cells and other components of the immune system, which has been taken as a basis for the hypotheses explaining the evident association of the above morbidities and delivery by cesarean section.
剖宫产技术和后勤保障方面的历史发展与进步降低了该手术相关的孕产妇和新生儿风险,同时却增加了因医学上不合理的原因而通过手术完成妊娠的数量。对剖宫产的不加批判的态度以及诸如年轻时的肥胖症、哮喘、1型糖尿病和各种形式的皮炎等“现代”疾病的迅速出现,激发了将剖宫产与这些疾病联系起来的研究。剖宫产出生的儿童肠道菌群中双歧杆菌较少,即他们的肠道菌群与糖尿病患者的肠道菌群相似。在剖宫产出生的儿童中,通常存在于母体产道和直肠中的“有益”母体细菌缺乏,而可能危及儿童免疫系统的“有害”细菌却经常存在。在顺产出生的儿童中,“有益”母体细菌会刺激新生儿的白细胞和免疫系统的其他成分,这被作为解释上述疾病与剖宫产明显关联的假说的依据。