Tirone Chiara, Paladini Angela, De Maio Flavio, Tersigni Chiara, D'Ippolito Silvia, Di Simone Nicoletta, Monzo Francesca Romana, Santarelli Giulia, Bianco Delia Mercedes, Tana Milena, Lio Alessandra, Menzella Nicoletta, Posteraro Brunella, Sanguinetti Maurizio, Lanzone Antonio, Scambia Giovanni, Vento Giovanni
Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Neonatologia, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, Rome, Italy.
Front Pediatr. 2022 Jul 22;10:909962. doi: 10.3389/fped.2022.909962. eCollection 2022.
The newborn's microbiota composition at birth seems to be influenced by maternal microbiota. Maternal vaginal microbiota can be a determining factor of spontaneous Preterm Birth (SP), the leading cause of perinatal mortality. The aim of the study is to investigate the likelihood of a causal relationship between the maternal vaginal microbiota composition and neonatal lung and intestinal microbiota profile at birth, in cases of SP. The association between the lung and/or meconium microbiota with the subsequent development of bronchopulmonary dysplasia (BPD) was also investigated. Maternal vaginal swabs, newborns' bronchoalveolar lavage fluid (BALF) (1st, 3rd, 7th day of life) and first meconium samples were collected from 20 women and 23 preterm newborns with gestational age ≤ 30 weeks (12 = SP; 11 = Medically Indicated Preterm Birth-MI). All the samples were analyzed for culture examination and for microbiota profiling using metagenomic analysis based on the Next Generation Sequencing (NGS) technique of the bacterial 16S rRNA gene amplicons. No significant differences in alpha e beta diversity were found between the neonatal BALF samples of SP group and the MI group. The vaginal microbiota of mothers with SP showed a significant difference in alpha diversity with a decrease in Lactobacillus and an increase in Proteobacteria abundance. No association was found between BALF and meconium microbiota with the development of BPD. Vaginal colonization by Ureaplasma bacteria was associated with increased risk of both SP and newborns' BPD occurrence. In conclusion, an increase in α-diversity values and a consequent fall in Lactobacillus in vaginal environment could be associated to a higher risk of SP. We could identify neither a specific neonatal lung or meconium microbiota profiles in preterm infants born by SP nor a microbiota at birth suggestive of subsequent BPD development. Although a strict match has not been revealed between microbiota of SP mother-infant couples, a relationship cannot be excluded. To figure out the reciprocal influence of the maternal-neonatal microbiota and its potential role in the pathogenesis of SP and BPD further research is needed.
新生儿出生时的微生物群组成似乎受母体微生物群影响。母体阴道微生物群可能是自发早产（SP）的一个决定性因素，而SP是围产期死亡的主要原因。本研究的目的是调查在SP病例中，母体阴道微生物群组成与新生儿出生时肺部和肠道微生物群谱之间存在因果关系的可能性。同时还研究了肺部和/或胎粪微生物群与支气管肺发育不良（BPD）后续发展之间的关联。从20名女性和23名孕周≤30周的早产新生儿（12例为SP；11例为医学指征早产-MI）中收集母体阴道拭子、新生儿支气管肺泡灌洗液（BALF）（出生后第1、3、7天）和首次胎粪样本。所有样本均进行培养检查，并使用基于细菌16S rRNA基因扩增子的下一代测序（NGS）技术进行宏基因组分析以进行微生物群谱分析。SP组和MI组新生儿BALF样本之间在α和β多样性方面未发现显著差异。患有SP的母亲的阴道微生物群在α多样性方面表现出显著差异，乳酸杆菌减少，变形菌丰度增加。未发现BALF和胎粪微生物群与BPD的发展之间存在关联。脲原体细菌的阴道定植与SP和新生儿BPD发生风险增加相关。总之，阴道环境中α多样性值增加以及随之而来的乳酸杆菌减少可能与SP风险较高有关。我们既未在SP出生的早产儿中识别出特定的新生儿肺部或胎粪微生物群谱，也未发现出生时的微生物群提示随后BPD的发展。尽管在SP母婴对的微生物群之间未发现严格匹配，但不能排除两者之间的关系。为了弄清楚母体-新生儿微生物群的相互影响及其在SP和BPD发病机制中的潜在作用，还需要进一步研究。
