The development of intestinal dysbiosis in anemic preterm infants

Objective Anemia and Proteobacteria-dominant intestinal dysbiosis in very low birth weight (VLBW) infants have been linked to necrotizing enterocolitis, a severe gut inflammatory disease. We hypothesize that anemia of prematurity is related to the development of intestinal dysbiosis. Study design Th...

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Bibliographic Details
Published inJournal of perinatology Vol. 40; no. 7; pp. 1066 - 1074
Main Authors Ho, Thao T. B., Kumar, Ambuj, Louis-Jacques, Adetola F., Dishaw, Larry J., Yee, Alyson L., Groer, Maureen W.
Format Journal Article
LanguageEnglish
Published New York Nature Publishing Group US 01.07.2020
Nature Publishing Group
Subjects
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692/308/575
692/699/1541/13
Analysis
Anemia
Birth weight
Dysbacteriosis
Enterocolitis
Hematocrit
Infants
Infants (Premature)
Inflammatory diseases
Intestine
Low-birth-weight
Medicine
Medicine & Public Health
Microbiomes
Necrotizing enterocolitis
Neonates
Newborn babies
Pediatric Surgery
Pediatrics
Premature babies
Proteobacteria
Risk analysis
Risk factors
RNA
rRNA 16S
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Summary:Objective Anemia and Proteobacteria-dominant intestinal dysbiosis in very low birth weight (VLBW) infants have been linked to necrotizing enterocolitis, a severe gut inflammatory disease. We hypothesize that anemia of prematurity is related to the development of intestinal dysbiosis. Study design Three hundred and forty-two weekly stool samples collected prospectively from 80 VLBW infants were analyzed for bacterial microbiomes (with 16S rRNA). Linear mixed-effects model was used to determine the relationships between the onsets of anemia and intestinal dysbiosis. Results Hematocrit was associated with intestinal microbiomes, with lower Hct occurring with increased Proteobacteria and decreased Firmicutes. Infants with a hematocrit <30% had intestinal microbiomes that diverged toward Proteobacteria dominance and low diversity after the first postnatal month. The microbiome changes were also related to the severity of anemia. Conclusions This finding supports a potential microbiological explanation for anemia as a risk factor for intestinal dysbiosis in preterm infants.
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Dr. Ho designed the study, collected clinical data, analyzed the 16S rRNA data, analyzed descriptive statistics, and prepared the manuscript. Dr. Groer advised on the study design, data collection, and microbiome analysis and revised the manuscript. Dr. Kumar advised on the study design, performed the statistical analysis on patient clinical and microbiome data, and revised the manuscript. Alyson Yee analyzed the 16S data into taxonomic percentages and diversity indices and revised the manuscript. Dr. Louis-Jacques performed literature review and manuscript preparation. Dr. Dishaw was advisor in the study design and manuscript preparation. All authors approved the final manuscript as submitted.
Author Contributions
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-020-0599-z