Impact of delivery mode in early life microbiome and risk of disease

Over the last few decades, and in spite of recommendations by the World Health Organization, the rate of cesarean section deliveries (CSD) has increased dramatically. This increase is not harmless, as numerous epidemiological studies have found an association with higher risk of developing metabolic and immune diseases later in the life of the infants. Although there are numerous factors involved in the pathogenesis of these conditions, it has been often suggested that CSD might be causally involved through perturbations in the early-life microbiome, as this procedure interrupts the natural transfer of vaginal microbiota to the newborn. In this chapter, we will summarize current knowledge on how CSD impacts early-life microbiome, how it might be associated with immune and metabolic diseases, and available approaches to modulate the microbiome following delivery by cesarean section.