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Factors Associated With the Microbiome in Moderate-Late Preterm Babies: A Cohort Study From the DIAMOND Randomized
Clara Yieh Lin Chong1, Tommi Vatanen1,2, Tanith Alexander1,3
1Liggins Institute, The University of Auckland, Auckland, New Zealand.
Insights
Socioeconomic status, hospital of birth, and maternal factors significantly influence the gut microbiome in preterm infants. Early life nutrition and medical interventions also shape infant gut bacteria development.
Area of Science:
- Microbiology
- Neonatal Health
- Gastroenterology
Background:
- The gut microbiome is crucial for infant health, particularly in preterm infants.
- Perinatal factors can significantly alter the gut microbiota composition and function.
- Understanding these influences is key to improving health outcomes for vulnerable infants.
Purpose of the Study:
- To investigate the impact of socioeconomic status, hospital of birth, maternal, and infant feeding factors on the gut microbiome of moderate-late preterm infants.
- To analyze gut microbiota composition at two key time points: Day-10 and 4-months corrected age.
- To identify specific microbial taxa and diversity patterns associated with various perinatal exposures.
Main Methods:
- Fecal samples collected from 227 moderate-late preterm infants at Day-10 and 4-months corrected age.
- 16S amplicon sequencing performed on 320 samples; shotgun metagenomic sequencing on 94 samples.
- Statistical analyses including Wilcoxon tests, linear models, and PERMANOVA used to assess associations.
Main Results:
- Lower socioeconomic status associated with higher alpha diversity and increased Bifidobacterium and Megasphaera abundance.
- Hospital of birth influenced microbial variance; Staphylococcus aureus more prevalent in samples from Middlemore hospital.
- Maternal antibiotic/probiotic use reduced Day-10 alpha diversity; infant probiotic intake increased Lactobacillus.
- Breastmilk feeding at 4 months correlated with reduced alpha diversity.
Conclusions:
- Maternal socioeconomic factors, hospital environment, and nutritional management significantly impact the developing gut microbiome in preterm infants.
- While causality cannot be definitively inferred, these findings highlight critical modifiable and non-modifiable factors influencing infant gut health.
- Further research is warranted to explore the long-term health implications of these microbiome alterations.
Abstract:
The gut microbiota of preterm infants is affected by perinatal factors and, in turn, may impact upon infant health. In this study, we collected fecal samples at Day-10 (D10) and 4-months corrected-age (4M) from 227 moderate-late preterm (MLPT) babies enrolled in a randomized controlled trial of nutritional management. A total of 320 samples underwent 16S amplicon sequencing, and shotgun metagenomic sequencing was performed on 94 samples from the 4M time point. The microbiome of babies whose families lived in lower socioeconomic status (SES) areas exhibited a significantly higher microbial alpha diversity at D10 (Wilcoxon test, p = 0.021), greater abundance of Bifidobacterium (linear model, q = 0.020) at D10 and Megasphaera (q = 0.031) at 4M. Hospital of birth explained 5.2% of the observed variance in 4M samples (PERMANOVA, p = 0.038), with Staphylococcus aureus more abundant in fecal samples from babies born in Middlemore hospital (linear model, q = 0.016). Maternal antibiotic (Wilcoxon test, p = 0.013) and probiotic (p = 0.04) usage within the four-week period before sample collection was associated with a reduction in the alpha diversity of D10 samples. Infant probiotic intake explained 2.1% (PERMANOVA, p = 0.021) of the variance in the D10 microbial profile with increased Lactobacillus (linear model, q = 1.1 × 10-10) levels. At 4M, the microbiome of infants who were breastmilk fed had reduced alpha diversity when compared to non-breastmilk fed infants (Wilcoxon test, p < 0.05). Although causality cannot be inferred within our study, we conclude that in MLPT babies, maternal socioeconomic factors, as well as the perinatal medical environment and nutrition impact on the development of the newborn microbiome.
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