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Decreased Acetic Acid in the Stool of Preterm Infants Is Associated with an Increased Risk of Bronchopulmonary

Lauren C Frazer1, William Yakah2, Camilia R Martin3

  • 1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

Nutrients
|June 24, 2022
PubMed

Insights

Low levels of acetic acid in preterm infants' stool are linked to a higher risk of bronchopulmonary disease (BPD). This suggests a connection between gut health and lung development in premature babies.

Area of Science:

  • Neonatal pathophysiology
  • Microbiome research
  • Gastroenterology and Pulmonology

Background:

  • Short-chain fatty acids (SCFAs), microbial metabolites, are understudied in neonatal diseases but linked to adult outcomes.
  • Investigating SCFA levels in maternal breastmilk and preterm infant stool is crucial for understanding neonatal morbidities.
  • Preterm infants (< 28 weeks gestation) are a vulnerable population requiring focused research on factors influencing their health.

Purpose of the Study:

  • To determine if SCFA levels in maternal breastmilk (BM) and preterm infant stool correlate with neonatal morbidities.
  • To assess the impact of specific SCFAs, particularly acetic acid, on the risk of bronchopulmonary disease (BPD) and retinopathy of prematurity (ROP).
  • To explore the relationship between gut microbiome metabolites and the development of common neonatal complications.

Main Methods:

  • Quantification of SCFA levels using liquid chromatography with tandem mass spectrometry.
  • Analysis of maternal BM and preterm infant stool samples (N=72) at postnatal days 14 and 28.
  • Comparison of SCFA levels in infants with and without BPD and ROP, employing logistic regression for association analysis.

Main Results:

  • SCFA levels, including acetic, propionic, and others, showed an increase in BM and infant stool from day 14 to 28.
  • A significant inverse relationship was found between fecal acetic acid levels and the odds of developing BPD.
  • Each quartile increase in fecal acetic acid was associated with reduced odds of BPD (OR 0.41 on day 14, 0.28 on day 28), but not ROP.

Conclusions:

  • Lower levels of acetic acid in preterm infant stool are associated with increased odds of bronchopulmonary disease.
  • These findings highlight a potential link between intestinal health, indicated by SCFA profiles, and pulmonary outcomes in preterm neonates.
  • The study supports the hypothesis that gut microbiome-derived metabolites play a role in neonatal health and disease development.

Keywords:
LC-MS/MSacetic acidbreast milkbronchopulmonary dysplasiamicrobiomeneonatespreterm infantsretinopathy of prematurityshort-chain fatty acidsstool

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