Microbial Translocation and Perinatal Asphyxia/Hypoxia: A Systematic Review

Abstract

The microbiome is vital for the proper function of the gastrointestinal tract (GIT) and the maintenance of overall wellbeing. Gut ischemia may lead to disruption of the intestinal mucosal barrier, resulting in bacterial translocation. In this systematic review, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, we constructed a search query using the PICOT (Patient, Intervention, Comparison, Outcome, Time) framework. Eligible studies reported in PubMed, up to April 2021 were selected, from which, 57 publications’ data were included. According to these, escape of intraluminal potentially harmful factors into the systemic circulation and their transmission to distant organs and tissues, in utero, at birth, or immediately after, can be caused by reduced blood oxygenation. Various factors are involved in this situation. The GIT is a target organ, with high sensitivity to ischemia–hypoxia, and even short periods of ischemia may cause significant local tissue damage. Fetal hypoxia and perinatal asphyxia reduce bowel motility, especially in preterm neonates. Despite the fact that microbiome arouse the interest of scientists in recent decades, the pathophysiologic patterns which mediate in perinatal hypoxia/asphyxia conditions and gut function have not yet been well understood.

Biomarkers of environmental enteric dysfunction and adverse birth outcomes: An observational study among pregnant women living with HIV in Tanzania

“…For example, intestinal damage resulting from low level ischemia or inflammation may share common pathways with placental insufficiency. 38 Increased microbial translocation has also been associated with reduced progesterone levels among pregnant PWLHIV, 39 which has been associated with preterm birth and may be associated with stillbirth. 40 Additional studies are needed to confirm our findings and to elucidate the potential mechanisms linking these maternal EED biomarkers to the risk of stillbirth.…”

Is acidemia at birth a risk factor for functional gastrointestinal disorders?

“…Matara and co-workers, in a recent systematic review [ 31 ], suggested that the GI tract is a target organ, with high sensitivity to ischemia–hypoxia, and even short periods of ischemia may cause significant local tissue damage. Fetal hypoxia and perinatal asphyxia reduce bowel motility, especially in preterm neonates.…”

Development of the Gastrointestinal Tract in Newborns as a Challenge for an Appropriate Nutrition: A Narrative Review

“…The relationship between microbiome and host is dynamic and many factors (such as genetic background, maternal diet prior to and during pregnancy, maternal microbiome, mode of delivery, gestational age, perinatal stress, infections during pregnancy and during the perinatal or neonatal period, feed type of neonates and especially of preterm infants, and other environmental factors such as temperature, humidity, pH, and oxygen levels in the tissues type) modulate the infants’ microbiome constitution and its dynamic relationship with the host, which can be transformed from ‘synbiotic’ to ‘dysbiotic’ and life-threatening [ 95 , 96 ].…”