A systematic review of associations between gut microbiota composition and growth failure in preterm neonates

Abstract

Growth failure is among the most prevalent and devastating consequences of prematurity. Up to half of all extremely preterm neonates struggle to grow despite modern nutrition practices. Although elegant preclinical models suggest causal roles for the gut microbiome, these insights have not yet translated into biomarkers that identify at-risk neonates or therapies that prevent or treat growth failure. This systematic review aims to identify features of the neonatal gut microbiota that are positively or negatively associated with early postnatal growth. We identified 860 articles, of which 14 were eligible for inclusion. No two studies used the same definitions of growth, ages at stool collection, and statistical methods linking microbiota to metadata. In all, 58 different taxa were associated with growth, with little consensus among studies. Two or more studies reported positive associations with Enterobacteriaceae, Bacteroides , Bifidobacterium , Enterococcus , and Veillonella , and negative associations with Citrobacter, Klebsiella , and Staphylococcus . Streptococcus was positively associated with growth in five studies and negatively associated with growth in three studies. To gain insight into how the various definitions of growth could impact results, we performed an exploratory secondary analysis of 245 longitudinally sampled preterm infant stools, linking microbiota composition to multiple clinically relevant definitions of neonatal growth. Within this cohort, every definition of growth was associated with a different combination of microbiota features. Together, these results suggest that the lack of consensus in defining neonatal growth may limit our capacity to detect consistent, meaningful clinical associations that could be leveraged into improved care for preterm neonates.

Gut microbiota development in very preterm infants following fortification of human milk

“…Interestingly, we found that the relative abundance of Staphylococcus was negatively correlated with bodyweight gain, consistent with previous results by Aguilar-Lopez et al [35]. Yet, a recent meta-analysis could not confirm a consistent link between Staphylococcus abundance and bodyweight gain [44], and the significance of these findings for BC-fortified VPIs remains to be clarified.…”

Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants

“…This process favors adequate colonization by harmless microorganisms that protect a newborn from pathogens. Adequate and diverse colonization positively influences the immune, metabolic, cognitive, and sensory development of a newborn [ 16 , 17 , 18 ]. The intestinal microbiota of a newborn is very simple at birth and is influenced by the type of delivery, the use of antibiotics, or the type of diet, with the MOM being one of the first sources of bacteria.…”