Intestinal Microbiome in Preterm Infants Influenced by Enteral Iron Dosing

Area of Science:

• Neonatal microbiome research
• Infant nutrition
• Gastrointestinal health

Background:

• Very low birth weight (VLBW) infants often require enteral iron supplementation (EIS).
• The impact of varying EIS doses on the developing intestinal microbiome in VLBW infants is not fully understood.

Purpose of the Study:

• To investigate the relationship between different enteral iron supplementation (EIS) doses and the intestinal microbiome composition and function in very low birth weight (VLBW) infants.

Main Methods:

• A prospective study involving 80 VLBW infants with longitudinal stool sample collection up to 2 months postnatally.
• 16S rRNA gene sequencing (V4 region) for microbiome composition analysis.
• Piphillin software for bacterial functional prediction, with statistical analysis using linear mixed effect models and Wilcoxon rank-sum tests.

Main Results:

• Infants receiving higher initial EIS doses (≥6 mg·kg⁻¹·day⁻¹) showed increased abundances of Proteus and Bifidobacterium compared to those on lower doses.
• Higher EIS doses were associated with reduced alpha diversity in the gut microbiome.
• Elevated predicted bacterial functional potentials for ferroptosis and epithelial invasion were observed in infants receiving higher EIS doses after 2 weeks.

Conclusions:

• Higher enteral iron supplementation doses in VLBW infants are associated with specific microbial shifts, including increased Proteus and Bifidobacterium, reduced diversity, and enhanced bacterial epithelial invasion potential.
• These findings suggest a potential link between EIS dosage and gut microbiome alterations.
• Further randomized controlled trials are warranted to establish optimal EIS dosages for VLBW infants.