Microbial Translocation and Perinatal Asphyxia/Hypoxia: A Systematic Review

Area of Science:

• Gastroenterology and Neonatal Medicine

Background:

• The gut microbiome is essential for gastrointestinal tract (GIT) function and overall health.
• Gut ischemia can compromise the intestinal barrier, allowing bacteria to translocate.
• The precise mechanisms linking perinatal hypoxia/asphyxia, gut function, and the microbiome remain unclear.

Purpose of the Study:

• To systematically review the literature on the impact of gut ischemia and perinatal hypoxia on the gut microbiome and intestinal barrier.
• To identify pathophysiological patterns mediating gut dysfunction under these conditions.

Main Methods:

• Systematic review conducted following PRISMA guidelines.
• Search query developed using the PICOT framework.
• Data extracted from 57 eligible publications indexed in PubMed up to April 2021.

Main Results:

• Reduced blood oxygenation (ischemia-hypoxia) can cause bacterial translocation from the gut to systemic circulation.
• The GIT is highly sensitive to ischemia-hypoxia, with even brief periods causing damage.
• Fetal hypoxia and perinatal asphyxia impair bowel motility, particularly in preterm neonates.

Conclusions:

• Perinatal hypoxia and gut ischemia significantly impact the gut microbiome and intestinal barrier function.
• Bacterial translocation is a key consequence, potentially affecting distant organs.
• Further investigation is crucial to elucidate the complex pathophysiological links in neonates.