Disrupted Maturation of the Microbiota and Metabolome among Extremely Preterm Infants with Postnatal Growth Failure.

Growth failure during infancy is a major global problem that has adverse effects on long-term health and neurodevelopment. Preterm infants are disproportionately affected by growth failure and its effects. Herein we found that extremely preterm infants with postnatal growth failure have disrupted maturation of the intestinal microbiota, characterized by persistently low diversity, dominance of pathogenic bacteria within the Enterobacteriaceae family, and a paucity of strictly anaerobic taxa including Veillonella relative to infants with appropriate postnatal growth. Metabolomic profiling of infants with growth failure demonstrated elevated serum acylcarnitines, fatty acids, and other byproducts of lipolysis and fatty acid oxidation. Machine learning algorithms for normal maturation of the microbiota and metabolome among infants with appropriate growth revealed a pattern of delayed maturation of the microbiota and metabolome among infants with growth failure. Collectively, we identified novel microbial and metabolic features of growth failure in preterm infants and potentially modifiable targets for intervention.

Duke Scholars

Author Noelle Elizabeth Younge Pediatrics, Neonatology

Author Christopher Bang Newgard Pharmacology & Cancer Biology

Author Charles Michael Cotten Pediatrics, Neonatology

Author Ronald Norman Goldberg Pediatrics, Neonatology

Author James R. Bain Medicine, Endocrinology, Metabolism, and Nutrition

Author Robert David Stevens Medicine, Endocrinology, Metabolism, and Nutrition

Author John F. Rawls Molecular Genetics and Microbiology

Author Patricia Lynn Ashley Pediatrics, Neonatology