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Published on: January 27, 2019
Effect of prophylactic dextrose gel on the neonatal gut microbiome
Sophie L St Clair1, Jane E Harding2, Justin M O'Sullivan1
1Liggins Institute, The University of Auckland, Auckland, New Zealand.
Insights
Dextrose gel, used to treat or prevent neonatal hypoglycemia, does not alter the infant gut microbiome. This finding reassures clinicians and parents about its safety for infant gut health.
Area of Science:
- Neonatal health
- Microbiome research
- Pediatric pharmacology
Background:
- Neonatal hypoglycemia is a common concern in newborns.
- Dextrose gel is a common intervention for neonatal hypoglycemia.
- The impact of dextrose gel on the infant gut microbiome is not well understood.
Purpose of the Study:
- To investigate the effect of prophylactic dextrose gel on the infant gut microbiome.
- To determine if dextrose gel alters microbiome diversity, composition, or stability.
Main Methods:
- An observational cohort study nested within the hypoglycaemia Prevention in newborns with Oral Dextrose (hPOD) trial.
- Infants at risk of neonatal hypoglycemia received prophylactic dextrose gel, placebo gel, or no gel (controls).
- Stool samples were collected on days 1, 7, and 28, with microbiome analysis using 16S rRNA gene amplicon sequencing.
Main Results:
- No significant differences in microbiome beta-diversity were observed between groups at 4 weeks (p=0.49).
- Alpha-diversity, bacterial DNA concentration, microbial community stability, and relative abundance of bacterial taxa also showed no significant differences.
- Exposure to dextrose gel (prophylaxis or treatment) did not affect the neonatal gut microbiome.
Conclusions:
- Dextrose gel, whether used for prophylaxis or treatment of neonatal hypoglycemia, does not alter the neonatal gut microbiome.
- Clinicians and consumers can be reassured regarding the safety of dextrose gel concerning infant gut microbiome development.
Objective:
To determine the effect of prophylactic dextrose gel on the infant gut microbiome.
Design:
Observational cohort study nested in a randomised trial.
Setting:
Three maternity hospitals in New Zealand.
Patients:
Infants at risk of neonatal hypoglycaemia whose parents consented to participation in the hypoglycaemia Prevention in newborns with Oral Dextrose trial (hPOD). Infants were randomised to receive prophylactic dextrose gel or placebo gel, or were not randomised and received no gel (controls). Stool samples were collected on days 1, 7 and 28.
Main Outcome Measures:
The primary outcome was microbiome beta-diversity at 4 weeks. Secondary outcomes were beta-diversity, alpha-diversity, bacterial DNA concentration, microbial community stability and relative abundance of individual bacterial taxa at each time point.
Results:
We analysed 434 stool samples from 165 infants using 16S rRNA gene amplicon sequencing. There were no differences between groups in beta-diversity at 4 weeks (p=0.49). There were also no differences between groups in any other microbiome measures including beta-diversity (p=0.53 at day 7), alpha-diversity (p=0.46 for day 7 and week 4), bacterial DNA concentration (p=0.91), microbial community stability (p=0.52) and microbial relative abundance at genus level. There was no evidence that exposure to any dextrose gel (prophylaxis or treatment) had any effect on the microbiome. Mode of birth, type of milk fed, hospital of birth and ethnicity were all associated with differences in the neonatal microbiome.
Conclusions:
Clinicians and consumers can be reassured that dextrose gel used for prophylaxis or treatment of neonatal hypoglycaemia does not alter the neonatal gut microbiome.
Trial Registration Number:
12614001263684.
