Dynamics of the preterm gut microbiome in health and disease

Abstract

Advances in metagenomics have allowed a detailed study of the gut microbiome, and its role in human health and disease. Infants born prematurely possess a fragile gut microbial ecosystem that is vulnerable to perturbation. Alterations in the developing gut microbiome in preterm infants are linked to life-threatening diseases such as necrotizing enterocolitis (NEC) and late-onset sepsis; and may impact future risk of asthma, atopy, obesity, and psychosocial disease. In this mini-review, we summarize recent literature on the origins and patterns of development of the preterm gut microbiome in the perinatal period. The host-microbiome-environmental factors that portend development of dysbiotic intestinal microbial patterns associated with NEC and sepsis are reviewed. Strategies to manipulate the microbiome and mitigate dysbiosis, including the use of probiotics and prebiotics will also be discussed. Finally, we explore the challenges and future directions of gut microbiome research in preterm infants.

Keywords: dysbiosis; gut microbiome; necrotizing enterocolitis; preterm; sepsis.

Graphical abstract

Figure 1.

Summary of antecedents and consequences of gut dysbiosis in preterm infants. Several prenatal, birth, and postnatal factors negatively impact the developing gut microbiome of the preterm infant. The resulting dysbiotic gut microbial communities during this critical period of development have been linked to both short-term and long-term morbidities. *Highlights factors considered to have relatively greater impact than others. Figure 1 created using www.biorender.com.