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Determinants of the Very Low-Birth-Weight Infant's Intestinal Microbiome: A Systematic Review

Katelyn Desorcy-Scherer1, Marion M Bendixen, Leslie A Parker

  • 1University of Florida College of Nursing, Gainesville, FL.

The Journal of Perinatal & Neonatal Nursing
|July 23, 2020
PubMed

Insights

The intestinal microbiome in very low-birth-weight infants is influenced by various factors, including feeding and antibiotic use. Understanding these determinants can help prevent gastrointestinal illnesses in this vulnerable population.

Area of Science:

  • Microbiology
  • Neonatology
  • Gastroenterology

Background:

  • The intestinal microbiome plays a crucial role in infant health, particularly in vulnerable very low-birth-weight (VLBW) infants.
  • VLBW infants experience unique challenges in establishing their initial intestinal microbiome.
  • Disruptions in the intestinal microbiome are linked to gastrointestinal illnesses like necrotizing enterocolitis and late-onset sepsis in VLBW infants.

Purpose of the Study:

  • To review the factors influencing the intestinal microbiome development in VLBW infants.
  • To discuss the clinical implications of these factors on infant health.
  • To identify potential strategies for supporting a healthy intestinal microbiome in VLBW infants.

Main Methods:

  • Systematic literature search of PubMed, Web of Science, EMBASE, and CINAHL.
  • Inclusion of publications focusing on factors affecting the VLBW infant intestinal microbiome.
  • Review and synthesis of identified determinants and their clinical relevance.

Main Results:

  • Infant age and weight, delivery mode, antibiotic exposure, medication use, feeding practices, environmental factors, and perinatal conditions are key determinants.
  • These factors significantly influence the establishment and composition of the VLBW infant intestinal microbiome.
  • Abnormal microbiome development is associated with increased risk of gastrointestinal morbidity.

Conclusions:

  • Clinicians can positively impact VLBW infant intestinal microbiome development.
  • Strategies include judicious antibiotic stewardship, promoting human milk feeding, and implementing strict hygienic practices.
  • Optimizing the intestinal microbiome is essential for reducing gastrointestinal illness in VLBW infants.

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