Stewart Christopher J, Embleton Nicholas D, Clements Elizabeth, Luna Pamela N, Smith Daniel P, Fofanova Tatiana Y, Nelson Andrew, Taylor Gillian, Orr Caroline H, Petrosino Joseph F, Berrington Janet E, Cummings Stephen P
Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, HoustonTX, United States.
Newcastle Neonatal ServiceRoyal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Front Microbiol. 2017 Jun 6;8:1008. doi: 10.3389/fmicb.2017.01008. eCollection 2017.
The short and long-term impact of birth mode on the developing gut microbiome in neonates has potential implications for the health of infants. In term infants, the microbiome immediately following birth across multiple body sites corresponds to birth mode, with increased in vaginally delivered infants. We aimed to determine the impact of birth mode of the preterm gut microbiome over the first 100 days of life and following neonatal intensive care unit (NICU) discharge. In total, 867 stool samples from 46 preterm infants (21 cesarean and 25 vaginal), median gestational age 27 weeks, were sequenced (V4 region 16S rRNA gene, Illumina MiSeq). Of these, 776 samples passed quality filtering and were included in the analysis. The overall longitudinal alpha-diversity and within infant beta-diversity was comparable between cesarean and vaginally delivered infants. Vaginally delivered infants kept significantly more OTUs from 2 months of life and following NICU discharge, but OTUs lost, gained, and regained were not different based on birth mode. Furthermore, the temporal progression of dominant genera was comparable between birth modes and no significant difference was found for any genera following adjustment for covariates. Lastly, preterm gut community types (PGCTs) showed some moderate differences in very early life, but progressed toward a comparable pattern by week 5. No PGCT was significantly associated with cesarean or vaginal birth. Unlike term infants, birth mode was not significantly associated with changes in microbial diversity, composition, specific taxa, or overall microbial development in preterm infants. This may result from the dominating effects of NICU exposures including the universal use of antibiotics immediately following birth and/or the lack of colonizing preterm infants.
出生方式对新生儿发育中的肠道微生物群的短期和长期影响对婴儿健康具有潜在意义。在足月儿中，出生后多个身体部位的微生物群与出生方式相对应，阴道分娩的婴儿中微生物群有所增加。我们旨在确定出生方式对早产肠道微生物群在生命最初100天及新生儿重症监护病房（NICU）出院后的影响。总共对46名早产儿（21名剖宫产和25名阴道分娩）的867份粪便样本进行了测序（V4区域16S rRNA基因，Illumina MiSeq），这些早产儿的中位胎龄为27周。其中，776份样本通过了质量过滤并纳入分析。剖宫产和阴道分娩的婴儿在总体纵向α多样性和婴儿内β多样性方面具有可比性。阴道分娩的婴儿在出生后2个月及NICU出院后保留的操作分类单元（OTU）明显更多，但基于出生方式，丢失、获得和重新获得的OTU并无差异。此外，优势菌属的时间进展在不同出生方式之间具有可比性，在对协变量进行调整后，任何菌属均未发现显著差异。最后，早产肠道群落类型（PGCT）在生命早期显示出一些适度差异，但到第5周时发展为类似模式。没有PGCT与剖宫产或阴道分娩显著相关。与足月儿不同，出生方式与早产儿微生物多样性、组成、特定分类群或整体微生物发育的变化无显著关联。这可能是由于NICU暴露的主导作用，包括出生后立即普遍使用抗生素和/或缺乏对早产儿的定植。
