Dunn Alexis B, Jordan Sheila, Baker Brenda J, Carlson Nicole S
Alexis B. Dunn is a Research Assistant Professor at the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. She can be reached via e-mail at
MCN Am J Matern Child Nurs. 2017 Nov/Dec;42(6):318-325. doi: 10.1097/NMC.0000000000000373.
The human microbiome plays a role in maintaining health, but is also thought to attenuate and exacerbate risk factors for adverse maternal-child health outcomes. The development of the microbiome begins in utero; however, factors related to the labor and birth environment have been shown to influence the initial colonization process of the newborn microbiome. This "seeding" or transfer of microbes from the mother to newborn may serve as an early inoculation process with implications for the long-term health outcomes of newborns. Studies have shown that there are distinct differences in the microbiome profiles of newborns born vaginally compared with those born by cesarean. Antibiotic exposure has been shown to alter the microbial profiles of women and may influence the gut microbial profiles of their newborns. Considering that the first major microbial colonization occurs at birth, it is essential that labor and birth nurses be aware of factors that may alter the composition of the microbiome during the labor and birth process. The implications of various activities and factors unique to the labor and birth environment that may influence the microbiome of women and newborns during the labor and birth process (e.g., route of birth, antibiotic use, nursing procedures) are presented with a focus on the role of labor nurses and the potential influence of nursing activities on this process.
人类微生物群系在维持健康方面发挥着作用，但也被认为会减弱和加剧母婴不良健康结局的风险因素。微生物群系的发育始于子宫内；然而，与分娩环境相关的因素已被证明会影响新生儿微生物群系的初始定植过程。这种从母亲到新生儿的微生物“播种”或转移可能作为一种早期接种过程，对新生儿的长期健康结局具有影响。研究表明，经阴道分娩的新生儿与剖宫产出生的新生儿相比，其微生物群系特征存在明显差异。抗生素暴露已被证明会改变女性的微生物特征，并可能影响其新生儿的肠道微生物特征。鉴于首次主要的微生物定植发生在出生时，分娩和接生护士必须了解在分娩过程中可能改变微生物群系组成的因素。本文介绍了分娩和接生环境中各种独特活动和因素在分娩过程中可能影响女性和新生儿微生物群系的情况（例如，分娩方式、抗生素使用、护理程序），重点关注分娩护士的作用以及护理活动对这一过程的潜在影响。
