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Elective cesarean delivery affects gut maturation and delays microbial colonization but does not increase necrotizing enterocolitis in preterm pigs.
- Source :
-
American journal of physiology. Regulatory, integrative and comparative physiology [Am J Physiol Regul Integr Comp Physiol] 2008 Mar; Vol. 294 (3), pp. R929-38. Date of Electronic Publication: 2007 Dec 26. - Publication Year :
- 2008
-
Abstract
- Although preterm birth and formula feeding increase the risk of necrotizing enterocolitis (NEC), the influences of cesarean section (CS) and vaginal delivery (VD) are unknown. Therefore, gut characteristics and NEC incidence and severity were evaluated in preterm pigs (92% gestation) delivered by CS or VD. An initial study showed that newborn CS pigs (n = 6) had decreased gastric acid secretion, absorption of intact proteins, activity of brush-border enzymes and pancreatic hydrolases, plasma cortisol, rectal temperature, and changes in blood chemistry, indicating impaired respiratory function, compared with VD littermates (n = 6). In a second experiment, preterm CS (n = 16) and VD (n = 16) pigs were given total parenteral nutrition (36 h) then fed porcine colostrum (VD-COL, n = 6; CS-COL, n = 6) or infant milk formula (VD-FORM, n = 10; CS-FORM, n = 10) for 2 days. Across delivery, FORM pigs showed significantly higher NEC incidence, tissue proinflammatory cytokines (IFN-gamma and IL-6), Clostridium colonization, and impaired intestinal function, compared with COL pigs. NEC incidence was equal for CS (6/16) and VD (6/16) pigs, CS pigs had decreased bacterial diversity and density, higher villus heights, and increased brush-border enzyme activities (lactase, aminopeptidases) compared with VD pigs. In particular, VD-FORM pigs showed reduced mucosal proportions, reduced lactase and aminopeptidases, and increased proinflammatory cytokine IL-6 compared with CS-FORM (P < 0.06). Despite the initial improvement of intestinal and metabolic functions following VD, gut function, and inflammation were similar, or more negatively affected in VD neonates than CS neonates. Both delivery modes exhibited positive and negative influences on the preterm gut, which may explain the similar NEC incidence.
- Subjects :
- Animals
Blood Chemical Analysis
Colostrum physiology
Cytokines metabolism
Diet
Enterocolitis, Necrotizing pathology
Fatty Acids metabolism
Female
Gastric Acidity Determination
Gastric Mucosa metabolism
Hydrogen-Ion Concentration
Intestinal Absorption physiology
Intestines pathology
Microvilli enzymology
Organ Size physiology
Parturition physiology
Polymorphism, Restriction Fragment Length
Pregnancy
Swine
Cesarean Section adverse effects
Enterocolitis, Necrotizing microbiology
Fetus physiology
Intestines growth & development
Intestines microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 0363-6119
- Volume :
- 294
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- American journal of physiology. Regulatory, integrative and comparative physiology
- Publication Type :
- Academic Journal
- Accession number :
- 18160527
- Full Text :
- https://doi.org/10.1152/ajpregu.00705.2007