Pregnancy-Induced Proinflammatory Immunological Tone and Gut Microbiota Profile are not Reversed at the Delivery

Rapid Communication

Austin J Public Health Epidemiol. 2022; 9(4): 1135.

Pregnancy-Induced Proinflammatory Immunological Tone and Gut Microbiota Profile are not Reversed at the Delivery

Hermansson H1*, Rautava S1,2, Löyttyniemi E3, Salminen S3 and Isolauri E1

¹Department of Paediatrics, University of Turku and Turku University Hospital, Finland

²Department of Pediatrics, University of Helsinki, and New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland

³Department of Biostatistics of University of Turku, Turku Finland

*Corresponding author: Henriina Hermansson, Department of Paediatrics, Turku University Hospital, 20520 Turku, Finland

Received: October 08, 2022; Accepted: November 02, 2022; Published: November 09, 2022


Pregnancy is associated with an increased production of pro-inflammatory factors and concomitant modifications in the gut microbiota composition. The persistence of these pregnancy-associated immunologic and gut microbiota profiles was assessed in 43 women. In the postpartum period the gut microbiota composition remained relatively unchanged while the concentrations of the proinflammatory cytokines continued to increase.

Keywords: Mode of delivery; Caesarean section; Inflammatory cytokines


CS Caesarean section, IL-8 interleukin-8, MCP-1 monocyte chemotactic protein-1, TNF- a tumor necrosis factor a.


Pregnancy is currently perceived as a critical stage in guiding the adaptation of foetus to the anticipated extrauterine environment and thereby impacting on the metabolic and immunological programming of child health. Carrying the pregnancy until term is ensured by a gradual modulation of the maternal immune system towards tolerance induction [1]. The metabolic features appear beneficial during pregnancy in shunting metabolic fuels to promote foetal growth, while the same profiles epitomize the metabolic syndrome in a non-pregnant situation [2,3]. We have previously demonstrated that the gut microbiota undergoes substantial changes over the course of pregnancy [4]. The precise interconnections between these alterations in gut microbiota composition and the maternal immunological tone remain obscure, as well as their restoration postpartum. An important question thus remains whether the delivery, and the delivery modes, reverse the microbial and immune tone to the pre-pregnant situation or does the pregnancy-induced alteration extend beyond the perinatal period.

Material and Methods

Patient Enrolment and Sample Collection

A nested case-control study based on a prospective intervention trial [5] was conducted. Altogether 46 women were studied: 10 women who had delivered by elective Caesarean Section (CS) and 13 women with non-elective CS were selected. and 23 women who delivered vaginally. The latter were chosen as controls and matched for pre-pregnancy body mass index, probiotic intervention during pregnancy as well as antibiotic exposure during pregnancy and labour. Written informed consent was obtained from all participants. The Ethics Committee of the Hospital District of Southwest Finland approved the study. Blood and faecal samples were been collected at the third trimester of pregnancy and one month postpartum. The concentrations of the cytokines Interleukin-8 (IL-8), Monocyte Chemotactic Protein-1 (MCP-1) and Tumour Necrosis Factor a (TNF-a) were measured from serum by using the Milliplex assay (Millipore, Billerica, MA) and the Luminex 200 system (Luminex Corporation, Austin, TX) according to manufacturer’s instructions. The composition of the gut microbiota was assessed by qPCR as described previously [6] using the ABI 7300 system (Applied Biosystems, Foster city, CA).

Statistical Analyses

The cytokine levels and microbial data are presented in medians and range and because of the skewness of the data. Wilcoxon signed rank test were used for comparison of two time points and Kruskal- Wallis test for the comparison between delivery methods. The statistical analyses were performed by using SAS Software Version 9.4.

Results and Discussion

The clinical characteristics of the women and the neonates in the study are presented in (Table 1a). All the children were born from metabolically healthy term pregnancies. There were no differences in the clinical characteristics among women with different delivery modes. The serum concentrations of IL-8, MCP-1 and TNF-a were significantly higher one month postpartum as compared to the third trimester of pregnancy (Table 1b) irrespective of the mode of delivery. The gut microbiota composition remained unchanged from the third trimester of pregnancy to the situation one month after delivery (Table 1c). However, Clostridium coccoides numbers were higher one month postpartum in mothers who had delivered vaginally as compared to those who had delivered by CS (p=0.0001).

Citation: Hermansson H, Rautava S, Löyttyniemi E, Salminen S and Isolauri E. Pregnancy-Induced Proinflammatory Immunological Tone and Gut Microbiota Profile are not Reversed at the Delivery. Austin J Public Health Epidemiol. 2022; 9(4): 1135.