Open AccessIntestinal Microbiome in Preterm Infants Influenced by Enteral Iron Dosing
Author(s) -
Ho Thao,
Sarkar Anujit,
Szalacha Laura,
Groer Maureen W.
Publication year - 2021
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003033
Subject(s) - medicine , microbiome , enteral administration , gestational age , bifidobacterium , gastroenterology , physiology , feces , birth weight , low birth weight , parenteral nutrition , pregnancy , microbiology and biotechnology , biology , lactobacillus , bioinformatics , food science , genetics , fermentation
Objectives: The aim of the study was to compare the intestinal microbiome in very low birth weight (VLBW) infants who received different enteral iron supplementation (EIS) doses. Study Design: Longitudinal stool collection in 80 VLBW infants were conducted up to 2 months postnatally in a prospective study. The 16S rRNA regions V4 was used to calculate microbiome compositions and the Piphillin software was used for bacterial functional prediction. Linear mixed effect models and Wilcoxon rank‐sum tests were performed to examine the relationships between initial EIS dosage and stool microbiome and bacterial functional potential. Results: There were 105 samples collected before and 237 collected after EIS started from infants with birth gestational age and weight of 28.1 ± 2.4 weeks and 1103 ± 210 g, respectively. The average postnatal age at start of EIS was 17.9 ± 6.9 days and the average initial EIS dose was 4.8 ± 1.1 mg · kg −1 · day −1 . Infants who were started on ≥6 mg · kg −1 · day −1 had higher abundances of Proteus and Bifidobacterium and a lower alpha diversity than those started on lower doses ( P < 0.05). Infants given higher EIS doses had higher bacterial predicted functional potentials for ferroptosis and epithelial invasion after 2 weeks post EIS. Conclusions: Higher EIS dosage is linked to higher abundances of Proteus and Bifidobacterium , and a less diverse microbiome and higher predicted potential of bacterial epithelial invasion. These observational findings should be further studied in a randomized study to elucidate the optimal dosage of EIS in VLBW infants.