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Updated: Jun 15, 2025
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Clinical sequelae of gut microbiome development and disruption in hospitalized preterm infants
Robert Thänert1, Drew J Schwartz2, Eric C Keen3
1The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Insights
Preterm infant gut microbiome development is significantly shaped by medical treatments, not just maternal factors. This study reveals key bacterial populations and links low-diversity microbiomes to necrotizing enterocolitis in premature infants.
Area of Science:
- Microbiome Research
- Neonatal Intensive Care Unit (NICU) Studies
- Pediatric Health
Background:
- Aberrant gut microbial colonization in preterm infants is linked to early-life disorders and long-term health issues.
- Understanding the dynamics of gut microbiome assembly in hospitalized preterm neonates is crucial for improving health outcomes.
Purpose of the Study:
- To characterize the gut microbiome dynamics during the first three months of life in preterm infants.
- To investigate the influence of medical interventions, maternal, and baseline variables on infant gut microbial composition.
- To identify microbial signatures associated with the development of necrotizing enterocolitis.
Main Methods:
- Shotgun metagenomics and metatranscriptomics were performed on stool samples from 236 preterm infants across three NICUs.
- Analysis included strain tracking, taxonomic and functional profiling, and integration with comprehensive clinical metadata.
- Longitudinal data collection covered the first three months of life.
Main Results:
- Enterobacteriaceae, enterococci, and staphylococci were identified as dominant colonizers of the preterm infant gut.
- Specific lineages of Clostridioides difficile and Staphylococcus epidermidis showed persistence within and between centers.
- Antibiotic and non-antibiotic medications had a greater impact on gut microbiome composition than maternal or baseline factors.
- Neonates who developed necrotizing enterocolitis after day 40 exhibited a persistent low-diversity gut microbiome.
Conclusions:
- Medical interventions significantly influence gut microbiome assembly in preterm infants, more so than maternal or baseline variables.
- Persistent low-diversity gut microbiomes are associated with the development of necrotizing enterocolitis in this vulnerable population.
- This study provides a comprehensive description of gut microbiome dynamics in response to medical interventions in hospitalized preterm neonates.
Abstract:
Aberrant preterm infant gut microbiota assembly predisposes to early-life disorders and persistent health problems. Here, we characterize gut microbiome dynamics over the first 3 months of life in 236 preterm infants hospitalized in three neonatal intensive care units using shotgun metagenomics of 2,512 stools and metatranscriptomics of 1,381 stools. Strain tracking, taxonomic and functional profiling, and comprehensive clinical metadata identify Enterobacteriaceae, enterococci, and staphylococci as primarily exploiting available niches to populate the gut microbiome. Clostridioides difficile lineages persist between individuals in single centers, and Staphylococcus epidermidis lineages persist within and, unexpectedly, between centers. Collectively, antibiotic and non-antibiotic medications influence gut microbiome composition to greater extents than maternal or baseline variables. Finally, we identify a persistent low-diversity gut microbiome in neonates who develop necrotizing enterocolitis after day of life 40. Overall, we comprehensively describe gut microbiome dynamics in response to medical interventions in preterm, hospitalized neonates.
