Impact of Perioperative Antibiotic Prophylaxis in Caesarean Section on the Maternal Gut Microbiome: A Systematic Review
Abstract
Background/Objectives: Caesarean section (CS) accounts for over 20% of global births and routinely involves perioperative antibiotic prophylaxis (PAP) to reduce surgical site infections. While the impact of such prophylaxis on neonatal microbiome development is well described, effects on the maternal gut microbiome remain underexplored. This systematic review synthesizes current evidence on how antibiotic prophylaxis during CS affects maternal gut microbiome composition and diversity—an underrepresented, but clinically relevant aspect of maternal–fetal medicine. Methods: A systematic literature search was conducted in Medline (PubMed), the Cochrane Library, and the WHO International Clinical Trials Registry Platform (ICTRP) through November 2024. Inclusion criteria were defined according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies used molecular techniques to report maternal gut microbiome outcomes (alpha- and beta-diversity). The search concentrated on beta-lactam antibiotics. Reference lists were screened, but no additional grey literature was searched. Synthesis followed the Synthesis Without meta-analysis (SWiM) approach. No review protocol was registered. The review received no external funding. Results: Out of 1011 records, three studies (total 286 mothers) met the inclusion criteria. All reported maternal microbiome outcomes secondarily to infant-focused research. Only one study provided pre- and…
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