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Influence of perinatal antibiotic on neonatal gut microbiota: a prospective cohort study

Faiza Iqbal1, Padmaja A Shenoy2, Leslie Edward S Lewis3

  • 1Department of Pediatrics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi District, Manipal, Karnataka, 576104, India.

BMC Pediatrics
|July 20, 2025
PubMed

Insights

Perinatal antibiotic exposure significantly alters the preterm infant gut microbiome, increasing pathogenic bacteria like Klebsiella pneumoniae and decreasing beneficial Bifidobacterium spp.

Area of Science:

  • Microbiology
  • Neonatal Medicine
  • Pediatrics

Background:

  • The gut microbiome plays a critical role in early immune and metabolic development.
  • Perinatal antibiotic administration significantly impacts the neonatal gut microbiome.
  • Understanding these effects is crucial for preterm infant health.

Purpose of the Study:

  • To investigate the impact of maternal and neonatal antibiotic exposure on the gut microbiome composition in preterm infants.
  • To compare microbiome profiles across different antibiotic exposure groups.

Main Methods:

  • Prospective controlled cohort study in a neonatal intensive care unit.
  • Inclusion of preterm infants (gestational age < 37 weeks).
  • Categorization into four groups: no exposure, infant exposure only, maternal exposure only, and both infant and maternal exposure. Stool sample analysis via convection culture.

Main Results:

  • Antibiotic exposure (infant, maternal, or both) increased the abundance of potentially pathogenic bacteria (Klebsiella pneumoniae, Escherichia coli).
  • Beneficial bacteria (Bifidobacterium spp.) were more abundant in infants with no antibiotic exposure.
  • Klebsiella pneumoniae prevalence significantly increased in infants with exposure by day 4.

Conclusions:

  • Perinatal antibiotic exposure is linked to significant alterations in the neonatal gut microbiota.
  • These changes may lead to an increased abundance of pathogenic bacteria.
  • Findings highlight the potential risks of antibiotic use in the perinatal period for preterm infants.
Abstract

Keywords:
Gut MicrobiomeMicrobial diversityNeonatal gut microbiotaPerinatal antibiotic exposurePreterm neonates

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