Impact of prematurity and nutrition on the developing gut microbiome and preterm infant growth

Abstract

BackgroundIdentification of factors that influence the neonatal gut microbiome is urgently needed to guide clinical practices that support growth of healthy preterm infants. Here, we examined the influence of nutrition and common practices on the gut microbiota and growth in a cohort of preterm infants.ResultsWith weekly gut microbiota samples spanning postmenstrual age (PMA) 24 to 46 weeks, we developed two models to test associations between the microbiota, nutrition and growth: a categorical model with three successive microbiota phases (P1, P2, and P3) and a model with two periods (early and late PMA) defined by microbiota composition and PMA, respectively. The more significant associations with phase led us to use a phase-based framework for the majority of our analyses. Phase transitions were characterized by rapid shifts in the microbiota, with transition out of P1 occurring nearly simultaneously with the change from meconium to normal stool. The rate of phase progression was positively associated with gestational age at birth, and delayed transition to a P3 microbiota was associated with growth failure. We found distinct bacterial metabolic functions in P1–3 and significant associations between nutrition, microbiota phase, and infant growth.ConclusionThe phase-dependent impact of nutrition on infant growth along with phase-specific metabolic functions suggests a pioneering potential for improving growth outcomes by tailoring nutrient intake to microbiota phase.Electronic supplementary materialThe online version of this article (10.1186/s40168-017-0377-0) contains supplementary material, which is available to authorized users.

The microbiome and metabolome of pre-term infant stool is personalized, and not driven by health outcomes including necrotizing enterocolitis and late-onset sepsis

“…Bacterial compositions in this cohort were consistent with the emerging picture from other studies that show the preterm infant gut harbors communities dominated by facultative anaerobes including Enterobacteriaceae , Enterococcus , and Staphylococcus (1, 2, 20). These communities appear to be enriched in commonly antibiotic resistant organisms (21).…”

Aberrant newborn T cell and microbiota developmental trajectories predict respiratory compromise during infancy

“…gCST 3 was the most diverse and mature gCST prior to discharge, and the earliest gCST in which Clostridia are prevalent. Notably, our previous study shows that the early presence of Clostridia in newborns predicts better growth velocity (6). Overall, the sparsity of these associations underscores the predominant role that host age plays in driving the abundance of T cell populations and microbiota composition.…”

“…), over the first 3 months of postnatal life (4). Likewise, there appears to be an age-related trajectory for gut and respiratory microbiota which, when disrupted by peri-and post-natal events, are associated with adverse outcomes such as atopy, stunted growth, and respiratory infection (5)(6)(7)(8)(9). Two recent studies demonstrated that the nasopharyngeal microbiome and virome together predict infant respiratory tract infection, but these studies left unresolved the microbiome's impact and dependency on immune development (10,11).…”

Neonatal gut and respiratory microbiota: coordinated development through time and space

“…Deficiency in colonization of pre-term infant gut microbiota has been associated with delays in immune development, alterations in host metabolism and inflammatory diseases such as necrotizing enterocolitis (NEC) [11, 27-31]. Longitudinal studies with pre-term infants have shown that the gut microbiota develops in a series of phases associated with postmenstrual age (PMA), more so than post-natal age, suggesting possible coordination between microbiota maturation and functional differentiation of the gut epithelium at defined stages of infant development [32]. Recent reports on neonatal respiratory microbiota have identified similar interactions of microbiota with mucosal epithelial and immune cells and an association with respiratory tract infections and chronic lung disease of prematurity [33-36].…”