Association between the gut microbiome and neurodevelopmental outcomes in infants with congenital heart disease: A prospective cohort study

Michael P Fundora ¹, Lily Dressner ², Christina Calamaro ^3,4

⁰Division of Pediatric Cardiology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Jpen. Journal of Parenteral and Enteral Nutrition +

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December 12, 2025

View abstract on PubMed

Summary

Children with congenital heart disease (CHD) show altered gut microbiomes linked to neurodevelopment. Lower microbial diversity and specific bacteria correlate with poorer cognitive and language scores in infants with CHD.

Area Of Science

Pediatric Cardiology
Neurodevelopmental Pediatrics
Microbiome Research

Background

Children with congenital heart disease (CHD) face significant risks for impaired neurodevelopmental outcomes.
The gut microbiome-brain axis is a potential pathway influencing neurodevelopment in these vulnerable children.
Early-life gut microbial composition is investigated for its association with neurodevelopmental trajectories.

Purpose Of The Study

To investigate the relationship between the early-life gut microbiome and neurodevelopmental outcomes in infants with CHD.
To identify specific microbial patterns associated with cognitive, language, and motor development.

Main Methods

A prospective cohort study was conducted in a cardiac intensive care unit.
Fecal samples were collected pre- and post-surgery and before discharge.
Neurodevelopmental assessments were performed using the Bayley Scales of Infant and Toddler Development between 9 and 12 months of age.
Microbial 16S rRNA gene sequencing and bioinformatics analyses were employed.

Main Results

Lower alpha diversity (Chao1) was associated with poorer cognitive (P=0.024) and language (P=0.018) scores.
Specific bacterial genera like Parabacteroides, Bacteroides, and Bifidobacterium were less abundant in children with lower cognitive scores.
Reduced Bifidobacterium and Enterococcus were linked to lower language scores.
Lower motor scores correlated with decreased Rothia and increased Serratia, Acinetobacter, and Proteus abundance.

Conclusions

Infants with CHD and lower cognitive/language scores exhibited reduced gut microbial diversity and less anti-inflammatory flora (e.g., Bifidobacterium).
Conversely, lower motor scores were associated with a higher abundance of pro-inflammatory bacteria (e.g., Serratia, Acinetobacter, Proteus).
Further research is essential to elucidate the longitudinal impact of gut dysbiosis on neurodevelopment in pediatric CHD patients.

Keywords:

cardiopulmonary bypass children congenital abnormalities gastrointestinal microbiome neurodevelopmental outcomes

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