Sezaryen Doğumlarda Kullanılan Profilaktik Antibiyotiklerin Yenidoğan Mikrobiyotası Üzerindeki Uzun Vadeli Etkileri: İnceleme Makalesi

Year 2024, Volume: 11 Issue: 3, 129 - 142, 31.12.2024

Teymur Bornaun , Hamit Zafer Guven

https://doi.org/10.56941/odutip.1538363

Abstract

Sezaryen doğumlarda (CS) kullanılan profilaktik antibiyotikler, yenidoğan sağlığı üzerinde önemli etkiler yaratarak bağırsak mikrobiyotasının erken kolonizasyonunu etkilemektedir. Cerrahi kesiden önce uygulanan bu antibiyotikler plasentayı geçerek fetüsü, bağışıklık sisteminin gelişiminde kritik bir aşamada mikrobiyal bozulmalara maruz bırakmaktadır. Bu çalışma, perinatal dönemde antibiyotik maruziyetinin yenidoğan bağırsak mikrobiyotası üzerindeki etkilerini ve bunun uzun vadeli sağlık sonuçlarını incelemektedir. Bulgular, antibiyotiklerin mikrobiyal çeşitliliği bozduğunu, Bifidobacterium gibi faydalı bakterilerin azalmasına ve fırsatçı patojenlerin kolonizasyonunun artmasına yol açtığını göstermektedir. Bu tür değişimlerin, ilerleyen yaşamda obezite, inflamatuvar bağırsak hastalıkları ve metabolik bozukluklar riskini artırdığı tespit edilmiştir. Anneye uygulanan antibiyotikler ayrıca, maternal vajinal ve bağırsak mikrobiyotasını değiştirerek mikrobiyal dikey geçişi etkilemekte ve anne sütü yoluyla antibiyotik kalıntılarına maruz kalmaya neden olmaktadır. Profilaktik antibiyotikler perinatal enfeksiyonları etkili bir şekilde azalttığı halde, yaygın kullanımları antibiyotik direnci ve uzun vadeli sağlık üzerindeki olumsuz etkilerle ilgili endişelere yol açmaktadır. Deneysel çalışmalar, kritik gelişim dönemlerinde tek bir terapötik dozun bile yenidoğanlarda kronik hastalıklara yatkınlık oluşturabilecek mikrobiyota değişimlerine neden olabileceğini göstermektedir. Bu çalışma, perinatal dönemde antibiyotik kullanımının dikkatle değerlendirilmesi gerektiğini, yenidoğan mikrobiyotasına yönelik olumsuz etkilerin en aza indirilmesi ve uzun vadeli sağlık sonuçlarının optimize edilmesi için modifiye edilebilir risk faktörlerinin belirlenmesinin önemini vurgulamaktadır. Enfeksiyon önlemenin faydaları ile mikrobiyota bozulmalarının risklerini dengelemek amacıyla klinik kılavuzların yeniden gözden geçirilmesi kritik öneme sahiptir.

Keywords

Profilaktik Antibiyotikler, Sezaryen Doğum, Yenidoğan Mikrobiyotası, Mikrobiyal Çeşitlilik

Exploring the Impact of Prophylactic Antibiotics During Cesarean Delivery on Neonatal Microbiota: A Comprehensive Review Article

Abstract

The use of prophylactic antibiotics during cesarean sections (CS) significantly impacts neonatal health by influencing the early colonization of the gut microbiota. Administered before surgical incision, these antibiotics cross the placenta, exposing the fetus to microbial disruptions at a critical stage of immune system development. This study examines the effects of perinatal antibiotic exposure on neonatal gut microbiota composition and its long-term health implications. Findings indicate that antibiotics disrupt microbial diversity, reduce beneficial bacteria like Bifidobacterium, and promote colonization by opportunistic pathogens. Such alterations have been linked to increased risks of obesity, inflammatory bowel disease, and metabolic disorders later in life. Maternal antibiotic use also affects vertical microbial transmission, altering the maternal vaginal and gut microbiota and exposing newborns to antibiotic residues through breast milk. While prophylactic antibiotics effectively reduce perinatal infections, their widespread use raises concerns about antibiotic resistance and long-term health consequences. Experimental studies show that even a single dose during critical developmental windows can predispose neonates to chronic diseases. This study highlights the need for careful evaluation of antibiotic use during the perinatal period to minimize adverse effects on neonatal microbiota and optimize long-term health outcomes. Identifying modifiable risk factors and refining clinical guidelines are essential steps toward balancing the benefits of infection prevention with the risks of microbiota disruption.

Keywords

Prophylactic Antibiotics, Cesarean Section, Neonatal Microbiota, Microbial Diversity

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