Division of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Division of Neonatology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Gut Microbes. 2023 Jan-Dec;15(1):2190301. doi: 10.1080/19490976.2023.2190301.
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, , , , and , and negative associations with , and . 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.
生长发育迟缓是早产儿最常见和最具破坏性的后果之一。尽管现代营养实践已经取得了进步，但仍有多达一半的极早产儿难以生长。虽然优雅的临床前模型表明肠道微生物组起着因果作用，但这些见解尚未转化为可以识别高危新生儿的生物标志物，也没有预防或治疗生长发育迟缓的治疗方法。本系统综述旨在确定与早期产后生长呈正相关或负相关的新生儿肠道微生物组特征。我们共确定了 860 篇文章，其中 14 篇符合纳入标准。没有两项研究使用相同的生长定义、粪便采集年龄以及将微生物组与元数据联系起来的统计方法。共有 58 个不同的分类群与生长有关，但研究之间几乎没有共识。两项或更多项研究报告了与肠杆菌科、、、、和呈正相关，与和呈负相关。在五项研究中，与生长呈正相关，在三项研究中与生长呈负相关。为了深入了解各种生长定义如何影响结果，我们对 245 份纵向采集的早产儿粪便进行了探索性二次分析，将微生物群落组成与多种临床相关的新生儿生长定义联系起来。在这个队列中，每种生长定义都与微生物群特征的不同组合相关。总之，这些结果表明，在定义新生儿生长方面缺乏共识可能限制了我们检测一致、有意义的临床关联的能力，而这些关联可能会被用于改善早产儿的护理。
