Association of blood transfusion-related di-(2-ethylhexyl) phthalate exposure with gut microbiota alterations in preterm infants
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Published on: February 17, 2023
Yung-Ning Yang1, Yu-Chen S H Yang2, San-Nan Yang1
1I-Shou University, E-DA Hospital, Department of Pediatrics, Kaohsiung, Taiwan; I-Shou University, College of Medicine, School of Medicine, Kaohsiung, Taiwan.
Insights
Exposure to Di-(2-ethylhexyl) phthalate (DEHP) via blood transfusions in preterm infants may alter gut microbiota, particularly increasing Enterococcus. Further research is needed to confirm these findings and their health impacts.
Area of Science:
- Neonatal Research
- Microbiome Studies
- Environmental Health
Background:
- Early-life exposure to environmental endocrine disruptors (EDCs) like Di-(2-ethylhexyl) phthalate (DEHP) is detrimental to neonatal health.
- Neonatal intensive care units (NICUs) present unavoidable DEHP exposure from medical devices.
- Blood transfusions in preterm infants can be a source of DEHP exposure.
Purpose of the Study:
- To investigate the impact of DEHP exposure from blood transfusions on gut microbiota development in preterm infants.
- To assess changes in gut bacterial composition and diversity following blood transfusion in a vulnerable neonatal population.
Main Methods:
- Prospective cohort study of preterm infants (May 2016-March 2021) with at least 7 days without antibiotics or transfusion prior to enrollment.
- Analysis of fecal samples using 16S rRNA gene sequencing before and after transfusion.
- Measurement of DEHP levels in post-transfusion blood products (average 0.072 ± 0.03 mg/mL).
Main Results:
- Overall blood transfusion did not significantly alter gut microbiota composition or diversity in preterm infants.
- A significant increase in Enterococcus abundance was observed in infants with lower postmenstrual age (PMA) and younger days of life (DOL).
Conclusions:
- Early-life DEHP exposure through blood transfusion may be associated with altered gut microbiota development.
- The observed increase in Enterococcus warrants further investigation.
- Additional research is necessary to establish causality and understand long-term health implications of DEHP exposure in neonates.
Objective:
Avoiding early-life exposure to environmental endocrine disruptors (EDCs) is critical for neonatal growth and long-term health. However, exposure to Di-(2-ethylhexyl) phthalate (DEHP), a typical EDC and plasticizer, is unavoidable in neonatal intensive care units due to contact with polyvinyl chloride medical devices.
Methods:
This study examined the impact of DEHP exposure through blood transfusion on gut microbiota development in preterm infants. To address this aim, the authors conducted a prospective cohort study, enrolling preterm infants between May 1, 2016, and March 30, 2021, who had not received blood transfusions or antibiotic treatment for at least seven consecutive days prior to enrollment. Fecal samples collected before and after transfusion underwent 16S ribosomal RNA gene-based next-generation sequencing analysis, while DEHP levels were measured in post-transfusion blood products. The average DEHP level in these products was 0.072 ± 0.03 mg/mL.
Results:
Initial analysis of 23 preterm infants (including five recruited twice) indicated that blood transfusion did not significantly alter bacterial composition and diversity. However, when examining recruitment events by postmenstrual age (PMA) or days of life (DOL), a significant increase in Enterococcus abundance was observed in both the lower PMA and younger DOL groups.
Conclusions:
These findings suggest a possible association between early-life DEHP exposure via blood transfusion and altered gut microbiota. Further studies are needed to clarify causality and long-term health implications.
