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J Matern Fetal Neonatal Med. 2019 May;32(9):1499-1506. doi: 10.1080/14767058.2017.1407310. Epub 2017 Nov 28.

Prenatal complications are associated with the postnatal airway host response and microbiota in intubated preterm infants.

Author information

1
a Department of Biostatistics, Colorado School of Public Health , University of Colorado , Aurora , CO , USA.
2
b Department of Epidemiology, Colorado School of Public Health , University of Colorado , Aurora , CO , USA.
3
c Department of Pediatrics, Section of Pulmonary Medicine , University of Colorado , Aurora , CO , USA.
4
d Department of Medicine, Section of Infectious Disease , University of Colorado , Aurora , CO , USA.
5
e Perinatal Institute, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
6
f Pediatric Heart-Lung Center, Department of Pediatrics , University of Colorado , Aurora , CO , USA.
7
g Department of Pediatrics, Section of Critical Care Medicine , University of Colorado , Aurora , CO , USA.

Abstract

PURPOSE:

To prospectively examine the relationship between prenatal events, postnatal airway host response and microbiota, and clinical outcomes.

MATERIALS AND METHODS:

Tracheal aspirates collected at seven days of age from 71 mechanically ventilated infants (median gestational age (GA), 25 weeks [range 23-28]) were simultaneously processed for a 12-plex protein assay and bacterial identification by 16S rRNA sequencing. Phenotypes were determined by unsupervised clustering of the protein analytes. Subject characteristics, microbial communities and clinical factors and outcomes were compared across the phenotype groups.

RESULTS:

Three clusters were identified: 1 (high protein levels), 2 (high proinflammatory proteins and low anti-inflammatory proteins), and 3 (low protein levels), respectively. Antenatal hemorrhage was most common in cluster 1, while chorioamnionitis characterized cluster 2 and preeclampsia was most prevalent in cluster 3, which was characterized by a predominance of Staphylococcus and relative absence of Ureaplasma. There were higher rates of adverse clinical outcomes in cluster 1.

CONCLUSIONS:

Airway protein profiles in seven days old mechanically ventilated preterm infants are associated with important antenatal events and unique airway microbial communities. These relationships may reveal new mechanisms by which antenatal events impact the course and outcomes of preterm infants.

KEYWORDS:

Preterm infants; airway microbiome; antenatal hemorrhage; chorioamnionitis; tracheal aspirate

PMID:
29157044
PMCID:
PMC6212338
[Available on 2020-05-01]
DOI:
10.1080/14767058.2017.1407310
[Indexed for MEDLINE]

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