Introduction: Approximately 30% of healthy infants are asymptomatically colonized with Clostridioides difficile (C. difficile). Infants colonized with this pathogen have an increased risk for allergic sensitization and atopy. This study aimed to examine the impact of maternal prenatal depression on the colonization of C. difficile in infants at 3-4 months of age.
Methods: This was a substudy of 1,500 term infants from the CHILD Cohort Study. Maternal reports were used to measure prenatal depression and feeding method. Birth mode was retrieved from hospital records. Fecal samples were collected at 3 months after home assessment. Analysis of C. difficile was performed using quantitative polymerase chain reaction (qPCR) with appropriate primers. Logistic regression was used to determine the association between maternal prenatal depression and C. difficile colonization at 3-4 months of age.
Results: In our sample, one-third (31%) of the infants were colonized with C. difficile at three months of age. During their third trimester of pregnancy, 24% of mothers reported clinically significant depressive symptoms. Prenatal depression significantly increased the odds of C. difficile colonization in the infant (Odds Ratio [OR]=1.44, 95% Confidence Interval [CI], 1.11-1.85; p=0.006), adjusted for birth mode and breastfeeding status. The odds of C. difficile colonization was significantly higher for both formula (p<0.001) and mixed feeding methods (p<0.001), as well as in infants born by caesarean section (p=0.002). The presence of C. difficile in the infant gut at age 3-4 months altered microbiota composition by enriching abundance of Rumminococcaceae and Lachnospiricaea, and depleting Bifidobacteriaceae.
Conclusion: At 3-4 months of age, infants of mothers who experienced prenatal depression had significantly increased risk of C. difficile colonization in their gut. Our findings further suggest that maternal mood may contribute to alterations in early infant microbiome, in addition to known infant gut microbiota determinants, such as feeding method and birth mode.
Vivien Obiakor– MSc Graduate Student, University of Alberta
Khanh Vu– PDF, University of Alberta
Stuart Turvey– Co-Director, CHILD study, The University of British Columbia
Padmaja Subbarao– CHILD Study Director, Univeristy of Toronto
James Scott– CHILD Study Investigator, University of Toronto
Anita Kozyrskyj– Adjunct Professor, University of Alberta
CHILD Study Investigators– CHILD Study Investigators, University of Toronto