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Background: The risk of neurodevelopmental disorders remains high in high-risk newborns. Cumulativeevidence reveals that gut microbiota plays an important role in neurodevelopment through the gut-brain axis. However, the composition of the neonatal gut microbiota and its association with neurodevelopment remain unclear. Methods: Neonates were recruited at the neonatal intensive care unit (NICU) of Hunan Children's Hospital from August 2018 to October 2019. Fecal samples within 3 months after birth, as well as neurodevelopmental outcomes using Neonatal Behavioral Neurological Assessment (NBNA) were collected. 16S rDNA gene sequencing was used to identify and quantify bacterial taxa, and estimated microbial composition in different groups. Results: A total of 94 newborns were enrolled and divided into four groups based on gestational age and neurodevelopmental outcome. We found that α diversity was not significant among groups. At the genus level, higher relative abundance of Streptococcus, and lower relative abundance of Bifidobacterium and Veillonella were associated with poor neurodevelopmental outcomes in preterm infants, while there was no difference in the gut microbial composition of full-term infants. Conclusions: Our findings suggest that alterations in the gut microbial community may be associated with a risk of neurodysplasia in preterm neonates. These findings may help understand the effects of gut microbiota on poor neurodevelopmental outcomes.

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