Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales (NSW), Australia.
Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.
Gut Microbes. 2021 Jan-Dec;13(1):1-30. doi: 10.1080/19490976.2021.1897210.
Early life, including the establishment of the intestinal microbiome, represents a critical window of growth and development. Postnatal factors affecting the microbiome, including mode of delivery, feeding type, and antibiotic exposure have been widely investigated, but questions remain regarding the influence of exposures on infant gut microbiome assembly. This systematic review aimed to synthesize evidence on exposures before birth, which affect the early intestinal microbiome. Five databases were searched in August 2019 for studies exploring pre-pregnancy or pregnancy 'exposure' data in relation to the infant microbiome. Of 1,441 publications identified, 76 were included. Factors reported influencing microbiome composition and diversity included maternal antibiotic and probiotic uses, dietary intake, pre-pregnancy body mass index (BMI), gestational weight gain (GWG), diabetes, mood, and others. Eleven studies contributed to three meta-analyses quantifying associations between maternal intrapartum antibiotic exposure (IAP), BMI and GWG, and infant microbiome alpha diversity (Shannon Index). IAP, maternal overweight/obesity and excessive GWG were all associated with reduced diversity. Most studies were observational, few included early recruitment or longitudinal follow-up, and the timing, frequency, and methodologies related to stool sampling and analysis were variable. Standardization and collaboration are imperative to enhance understanding in this complex and rapidly evolving area.
生命早期，包括肠道微生物组的建立，是生长和发育的关键窗口期。人们广泛研究了影响微生物组的产后因素，包括分娩方式、喂养类型和抗生素暴露，但关于暴露对婴儿肠道微生物组组装的影响仍存在疑问。本系统评价旨在综合与婴儿微生物组相关的产前暴露的证据。2019 年 8 月，我们在五个数据库中搜索了探索与婴儿微生物组相关的孕前或孕期“暴露”数据的研究。在确定的 1441 篇论文中，有 76 篇被纳入。报告的影响微生物组组成和多样性的因素包括母亲抗生素和益生菌的使用、饮食摄入、孕前体重指数（BMI）、孕期体重增加（GWG）、糖尿病、情绪等。11 项研究参与了三项荟萃分析，定量评估了母亲产时抗生素暴露（IAP）、BMI 和 GWG 与婴儿微生物组α多样性（香农指数）之间的关联。IAP、母亲超重/肥胖和 GWG 过多都与多样性降低有关。大多数研究为观察性研究，很少有研究进行早期招募或纵向随访，粪便取样和分析的时间、频率和方法学也各不相同。标准化和协作对于在这个复杂且快速发展的领域增强理解至关重要。
