Microbiotas from extremely preterm infants with growth faltering impair postnatal growth and metabolism in mice

Kwai Tei Chan Poon1, Se Hyang Han1, Olga Ilkayeva2,3

  • 1Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.

JCI Insight
|June 23, 2026
PubMed

Insights

Altered gut microbiota in preterm infants with poor growth impairs development. Modifying the intestinal microbiota in mice with poor growth restored normal postnatal growth, suggesting a therapeutic target.

Area of Science:

  • Microbiology
  • Neonatal Development
  • Gastroenterology

Background:

  • Postnatal growth faltering is common in extremely preterm infants and linked to poor neurodevelopment.
  • Preterm infants with poor growth exhibit altered intestinal microbiota development compared to those with appropriate growth.

Purpose of the Study:

  • To investigate if differences in intestinal microbiota development independently contribute to postnatal growth faltering in extremely preterm infants.
  • To explore the potential of microbiota modification as a therapeutic strategy for growth impairment.

Main Methods:

  • Gnotobiotic mice were colonized with intestinal microbiotas from extremely preterm infants with either poor or appropriate growth.
  • Metabolic profiles, including hepatic acylcarnitines and circulating ketones, were analyzed to assess lipolysis and fatty acid oxidation.
  • Intervention studies involved postnatal treatment with microbiotas from infants with appropriate growth in mice previously colonized with microbiotas from infants with poor growth.

Main Results:

  • Colonization of neonatal mice with microbiotas from preterm infants with poor growth resulted in postnatal growth impairment.
  • This impairment was associated with a metabolic signature of enhanced lipolysis and fatty acid oxidation.
  • Postnatal microbiota treatment with samples from infants with appropriate growth successfully prevented growth impairment in affected mice.

Conclusions:

  • Altered intestinal microbiota development is a contributing factor to postnatal growth faltering in extremely preterm infants.
  • Microbiota modification holds promise as a strategy to restore normal postnatal growth in this vulnerable population.

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