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Association between the gut microbiome and neurodevelopmental outcomes in infants with congenital heart disease: A
Michael P Fundora1, Lily Dressner2, Christina Calamaro3,4
1Division of Pediatric Cardiology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Insights
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.
Background:
Children with congenital heart disease are at risk for poor neurodevelopment. The gut microbiome may influence neurodevelopmental outcomes through the gut-brain axis. This study investigated the association of early-life gut microbiome with neurodevelopmental outcomes.
Methods:
A prospective cohort study was conducted in the cardiac intensive care unit. Fecal samples were collected before surgery, after surgery, and before discharge. Neurodevelopmental testing used Bayley Scales of Infant and Toddler Development between 9 and 12 months. Microbial data of the 16S ribosomal RNA V4 region were processed. Microbiome data were analyzed using Quantitative Insights Into Microbial Ecology 2 and MicrobiomeAnalyst 2.0.
Results:
Twenty-four patients were analyzed: 15 (62.5%) were male and 12 (50%) were White. Children with lower cognitive (Chao1 P = 0.024) and language scores (Chao1 P = 0.018) had lower alpha diversity; beta diversity showed marginally significant dissimilarities (Jaccard P = 0.102 and P = 0.051, respectively). Lower cognitive scores were associated with less Parabacteroides (P = 0.031), Bacteroides (P = 0.041), and Bifidobacterium (P = 0.047), and lower language scores were associated with less Bifidobacterium (P = 0.044) and Enterococcus (P = 0.024). Lower motor scores were associated with less Rothia (P = 0.017) but a higher abundance of Serratia (P < 0.001), Acinetobacter (P = 0.016), and Proteus (P = 0.013).
Conclusion:
Children with congenital heart disease with lower cognitive and language scores had lower diversity and less anti-inflammatory flora (eg, Bifidobacterium), whereas those with lower motor scores had a higher abundance of pro-inflammatory flora (eg, Serratia, Acinetobacter, and Proteus). Further studies are needed to understand the longitudinal effect of gut microbial dysbiosis on neurodevelopment in children with congenital heart disease.
