In this video Dr. David Perlmutter discusses the potential metabolic consequences of being born by cesarean section (C‑section). He begins by noting the high prevalence of C‑sections in the United States (≈33% of births) and emphasizes that while the procedure can be life‑saving, emerging research suggests it may disrupt the newborn’s initial microbiome, possibly affecting long‑term health. Perlmutter references Dr. Maria Domínguez‑Bello’s work on “vaginal seeding,” a technique that transfers microbes from the birth canal to C‑section‑born infants, and cites a recent Nature paper showing that specific birth‑canal organisms can be detected in stool up to six months after such inoculation. He then reviews a new NYU rodent study titled “Increased Weight Gain by C‑Section: Functional Significance of the Primordial Microbiome,” which compared weight trajectories of mice delivered by C‑section versus vaginal birth. The study, conducted without perinatal antibiotics (unlike typical human C‑sections), found that C‑section‑born mice, especially females, gained significantly more weight over time. Perlmutter highlights the study’s limitation that the exact timing of the overweight phenotype could not be pinpointed before weaning. He also stresses that antibiotics administered during human C‑sections further alter the microbiome, complicating direct translation of the animal findings. Concluding, he calls for continued monitoring of this evolving evidence base, noting the importance of understanding how early microbial exposure may influence metabolic development.
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Hello everyone, Dr. David Perlmutter here. You know, we've been talking quite a bit about the effects of being born by cesarean section in terms of outcome prediction with respect to the health of a child and even an adult. And again, as I've said many times, there's certainly a time and a place for C-section. It is a life-saving procedure. Some have estimated that about 10 to 15% of births here in America are requiring cesarean section. We know that about a third of all births, about 33% of all births in America is now via C-section. So it's really important that we stay on top of the literature to understand what might be the mechanisms that are involved here in the detrimental effects of being born By C-section. Having said that, I have quoted the work in the past of Dr. Maria Dominguez Bello, who has described the technique in humans of actually saving a bit of the microbiome from the birth canal and inoculating a child's newborn's mouth and eyes and nose with material from the birth canal as a way of giving that child. And exposure to the types of microbes that he or she would have received had he or she been born vaginally. Really interesting information. She has a recent paper in the journal Nature that talks about recovery of specific birth canal organisms up to 6 months later in the stool of a newborn, now a child, a neonate, who has in fact been exposed to this type of procedure. So having said that, her group at NYU has recently put out a paper just this past couple of weeks. It's entitled Increased Weight Gain by C-Section: Functional Significance of the Primordial Microbiome. And what they've done in this study— it is an animal study, it is a rodent study— they simply compared the weight of these laboratory rodents born either C-section or born vaginally over time. And interestingly, their group calls a very important point out, and that is unlike humans, or at least Americans born by C-section, these animals did not receive antibiotics. We know that here in America, if a woman has a C-section, then antibiotics are considered basically mandatory. We do know that antibiotics also have an effect upon the microbiome. Having said that, the group found some very interesting findings. And again, this is animal work, but if you look at this first image, this is change in body mass over time comparing those animals born by C-section, which are seen in the red curve, versus those born by vaginal delivery in the blue curve. And interestingly enough, there was a significant difference in comparing it, as you see in this next slide, females to males. And it looks as if females were far more susceptible to weight gain when they were born via cesarean section. And again, I think it's really important to note that these are— this laboratory situation is one in which No antibiotics were used. Let me read from the discussion. Discussion: one limitation of this work was that we could not tell with precision when the phenotype— means above being overweight— arose before weaning, which is the time when C-section offspring had already gained significantly more weight than the vaginally born controls. But more importantly, The researchers go on to say that unlike the procedure in humans, C-sections were performed in this work without the use of perinatal antibiotics. Now we know that antibiotics have a dramatic effect again on the microbiome. So again, this is a laboratory study with laboratory animals, but I think it drives home the point that there are significant changes, in this case with respect to body weight, that seem to be imparted when the gut bacteria are altered via the process of being born by cesarean section. Interesting information, and we will continue to watch as this story evolves. I'm Dr. David Perlmutter, and thanks for watching.
