Methods: The study population comprised 412 infants from the Cohort for Childhood of Asthma and Allergic Diseases (COCOA). Their cord blood DNA was subjected to IL13 (rs20541) and CD14 (rs2569190) genotype analysis. Fecal samples were obtained from 11 of the 412 infants in this study at the age of 6 months and 16s rRNA bacterial gene sequencing was performed.
Results: The combination of cesarean delivery and prenatal exposure to antibiotics associated significantly and positively with AD (aOR, 5.70; 95% CI, 1.19–27.3). The association between cesarean delivery and AD was significantly modified by parental history of allergic diseases or risk-associated IL-13 (rs20541) and CD14 (rs2569190) genotypes. Infants who were exposed prenatally to antibiotics and were born by cesarean delivery had lower total microbiota diversity in stool samples at 6 months of age than the control group. As the number of these risk factors increased, the AD risk rose (trend p<0.05).
Conclusion: Cesarean delivery and prenatal antibiotic exposure may affect the gut microbiota, which may in turn influence the risk of AD in infants. These relationships may be shaped by the genetic susceptibility alleles.