This review describes current understandings about the nature of the very low birth weight infant (VLBW) gut microbiome. VLBW infants often experience disruptive pregnancies and births, and prenatal factors can influence the maturity of the gut and immune system, and disturb microbial balance and succession. Many VLBWs experience rapid vaginal or Caesarean births. After birth these infants often have delays in enteral feeding, and many receive little or no mother's own milk. Furthermore the stressors of neonatal life in the hospital environment, common use of antibiotics, invasive procedures and maternal separation can contribute to dysbiosis. These infants experience gastrointestinal dysfunction, sepsis, transfusions, necrotizing enterocolitis, oxygen toxicity, and other pathophysiological conditions that affect the normal microbiota. The skin is susceptible to dysbiosis, due to its fragility and contact with NICU organisms. Dysbiosis in early life may resolve but little is known about the timing of the development of the signature gut microbiome in VLBWs. Dysbiosis has been associated with a number of physical and behavioral problems, including autism spectrum disorders, allergy and asthma, gastrointestinal disease, obesity, depression, and anxiety. Dysbiosis may be prevented or ameliorated in part by prenatal care, breast milk feeding, skin to skin contact, use of antibiotics only when necessary, and vigilance during infancy and early childhood.
Keyphrases
- low birth weight
- preterm infants
- preterm birth
- gestational age
- early life
- human milk
- birth weight
- healthcare
- mental health
- microbial community
- soft tissue
- autism spectrum disorder
- pregnant women
- oxidative stress
- public health
- weight gain
- chronic obstructive pulmonary disease
- wound healing
- palliative care
- metabolic syndrome
- pregnancy outcomes
- intensive care unit
- type diabetes
- weight loss
- insulin resistance
- acute kidney injury
- risk assessment
- physical activity
- skeletal muscle
- emergency department
- gram negative
- body mass index
- adipose tissue
- sensitive detection
- liquid chromatography
- attention deficit hyperactivity disorder
- health insurance
- affordable care act
- oxide nanoparticles
- drug induced
- air pollution
- quality improvement