Am J Perinatol 2021; 38(11): 1142-1149
DOI: 10.1055/s-0040-1710554
Original Article

Early Gut Microbiota Changes in Preterm Infants with Bronchopulmonary Dysplasia: A Pilot Case–Control Study

Shan-Ming Chen
1   Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
2   Department of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
Ching-Pin Lin
3   Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
4   Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
4   Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
5   Immunology Research Center, Chung Shan Medical University, Taichung, Taiwan
6   Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan
› Author Affiliations
Funding This study was supported by research grants from Chung Shan Medical University Hospital, Taiwan (CSH-2016-C-30).


Objective Bronchopulmonary dysplasia (BPD) is a complex chronic lung disease that primarily affects premature or critically ill infants. This pilot study investigated early changes in gut microbiota composition in BPD patients and explored the potential risk factors associated with these changes.

Study Design Preterm infants admitted to our neonatal intensive care unit with a gestational age of 26 to 32 weeks were prospectively surveyed and eligible for stool collection on days 7 and 28 of postnatal age between February 2016 and June 2017. A 16S rRNA sequencing approach was applied to compare the gut microbiota composition between the BPD group and controls. Multiple linear regression analysis was used to identify the predictor variables.

Results Eight subjects in the BPD group and 10 subjects in the preterm group were analyzed during the observation period. Actinobacteria, Proteobacteria, Bacteroidetes, and Firmicutes were the four dominant bacteria phyla of intestinal microflora. A significantly lower diversity of gut microbiota was observed in the BPD group compared with the preterm group on day 28 (number of observed operational taxonomic units, p = 0.034; abundance-based coverage estimator, p = 0.022; Shannon index, p = 0.028). Multiple linear regression analysis revealed that high Neonatal Therapeutic Intervention Scoring System score (≧19) at 24 hours was statistically significant in predicting the proportion of aerobic with facultative anaerobic bacteria on day 28 (p = 0.002).

Conclusion Infants with BPD are prone to develop gut dysbiosis in early life. A higher severity of illness and treatment intensity may indicate a higher risk of disrupting an anaerobic environment in the gut during the first month of life.

Key Points

  • BPD patients are prone to develop gut dysbiosis.

  • Lower diversity of gut microbiota.

  • Higher risk of disrupting anaerobic environment.

Publication History

Received: 22 September 2019

Accepted: 09 April 2020

Article published online:
23 May 2020

© 2020. Thieme. All rights reserved.

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