Growth problems in preterm neonates associated with a modified intestinal bacteria



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A new study suggests that premature babies who do not grow as expected or thrive may have problems with the development of their microbiome.

A team of researchers at the Ann & Robert H. Lurie Children's Hospital in Chicago found that extremely premature babies did not grow while others developed normally because of certain metabolic differences caused by alterations. specific intestinal microbiome.

The study, published in the journal Scientific reports, shows that the reason why premature babies fail to flourish or develop normally, unlike other infants despite similar caloric intake, is because their body reacts as if it were with an empty stomach. The study also suggests that the unique composition of intestinal bacteria could also be related to their inability to properly metabolize certain nutrients.

"Our identification of the distinct microbiome and metabolism features badociated with stunting may provide new ways to predict, prevent and treat this pervasive problem in premature infants," said Dr. Patrick Seed, Senior Research Scientist in Science. Fundamental to Ann & Robert H. Lurie Chicago Children's Hospital and co-author of the study said.

He added that current medications do not identify infants with the highest risk of growth failure. The microbiome study could pave the way for individualized care for premature babies.

Lactobacillus bacteria, 3D illustration. Normal flora of the small intestine, lactic acid bacteria. Illustration credit: Kateryna Kon / Shutterstock

Lactobacillus bacteria, 3D illustration. Normal flora of the small intestine, lactic acid bacteria. Illustration credit: Kateryna Kon / Shutterstock

Prematurity and baby's needs

During the first months of life of a premature baby, the focus is primarily on critical care providing the nutrients needed for healthy development. In recent decades, the quality of care and nutritional practices for premature babies has improved dramatically. These had allowed many babies to cope well with early childhood and become healthy children.

However, some infants may have nutrition problems and not progress at the same rate as their peers. In addition, some premature babies seem unable to metabolize nutrients are effective like others. The researchers believe that differences in the composition of the intestinal microbiome could play a key role in the baby's ability to develop normally.

Intestinal bacteria

The gastrointestinal tract is made up of thousands of billions of microbes. This means that there are more intestinal bacteria in the digestive tract than cells in the body. From there, there are at least 400 species of bacteria. These are essential for the digestion of foods, the synthesis of nutrients and vitamins and the fight against harmful pathogens. Overall, they are essential for overall health.

Research shows that the specific characteristics of the microbiome are major factors in the onset of certain conditions, including asthma, obesity, allergies, diabetes, depression, autoimmune diseases and some types of cancer.

In addition, among premature infants, some studies have shown that their bacterial composition in the intestines was significantly different in those born at the appropriate age.

"In our study, we investigated the relationships between the gut microbiome, metabolism, and growth in preterm infants.The significant badociations we found will need to be replicated by other studies in the future "explained Dr. Seed.

The new study involved 58 premature babies, all of whom were 26 weeks old on average. At the age of 40 weeks, about 60% of babies had a severe postnatal growth deficit, which meant that their weight was below the third percentile shown on the growth charts.

In addition, 36 infants were stunted and the rest developed normally. In addition, the groups exhibited persistent differences with respect to intestinal bacteria and their metabolism regardless of complications related to prematurity, including intestinal perforation, intestinal inflammation or necrotizing enterocolitis, as well as Infection or blood sepsis.

They also found that premature infants, particularly those who did not grow up, had an alteration in the maturation of intestinal bacteria. They also found delayed metabolic development, suggesting deficiencies in the metabolism of glucose and other non-lipid compounds. They therefore depend on fatty acids. Infants are in a consistent state like fasting.

"This could explain why the simple increase in caloric intake of stunted infants often does not work. In order to develop effective treatments, we need to better understand how their inability to use nutrients as a source of energy is influenced by the delayed maturation of the microbiome and its metabolism, "added Dr. Seed.

The researchers believe that the study, specifically comparing the microbiome and infant metabolism, can help improve premature baby development and future interventions.

Journal reference:

Younge, N., C. Newgard, M., Goldberg, R., Muehlbauer, MJ, Bain, J., Stevens, R., O. Connell, Rawls, J., Seed, P. and Ashley. P. (2019). Disturbed microbiota and metabolome maturation in extremely premature newborns with postnatal growth retardation. Scientific reports. https://www.nature.com/articles/s41598-019-44547-y

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