Open Access

Elisabeth Feles, Frauke Mattner, Claudio Neidhöfer, Martin Sieber, Stefan Leuko, Ralf Moeller

• Background: The global rate of Caesarean section (CS) is 21.1 % (2021) and is rising worldwide. CS presents the third highest cumulative incidence for surgical site infections. Maternal infections around the time of childbirth account for 1 out of 10 maternal deaths worldwide. Therefore, perioperative antibiotic prophylaxis (PAP) during CS is common standard of care and part of numerous recommendations from expert bodies such as the World Health Organization (WHO) and different national gynecological professional associations. According to these, first and second generation cephalosporins like cefuroxime are the agents of choice for this indication. In fact, the use of PAP significantly reduces maternal morbidity and mortality rates. Whereas the side effect of this measure on the microbiome of the newborn has been the subject of repeated clinical studies, data on specific and especially long-term effects on the gut microbiome of the mothers are still lacking. MAMA is the first study to specifically and systematically investigate this question.