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Koerner R, Bendixen MM, Monk A, Lamberti MF, Lorca GL, Neu J, Parker LA. A Scoping Review of the Oral Microbiome in Preterm Infants. Am J Perinatol 2024; 41:e2990-e3002. [PMID: 37907200 PMCID: PMC11058105 DOI: 10.1055/s-0043-1776344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
The purpose of this scoping review was to examine the oral microbiome composition in preterm infants, sampling and collection methods, as well as exposures associated with oral microbiome composition and health implications. We conducted a scoping review of the literature using the Arskey and O'Malley framework. We identified a total of 13 articles which met our inclusion criteria and purpose of this scoping review. Articles included in this review compared the oral microbiome in preterm infants to term infants, examined alterations to the oral microbiome over time, compared the oral microbiome to different body site microbiomes, and explored associations with clinically relevant covariates and outcomes. Exposures associated with the diversity and composition of the oral microbiome in preterm infants included delivery mode, oral feeding, oropharyngeal care, skin-to-skin care, and antibiotics. Day of life and birth weight were also associated with oral microbiome composition. The oral microbiome may be associated with the composition of the tracheal and gut microbiomes, likely due to their proximity. Alpha and beta diversity findings varied across studies as well as the relative abundance of taxa. This is likely due to the different sampling techniques and timing of collection, as well as the wide range of infant clinical characteristics. Multiple factors may influence the composition of the oral microbiome in preterm infants. However, given the heterogeneity of sampling techniques and results within this review, the evidence is not conclusive on the development as well as short- and long-term implications of the oral microbiome in preterm infants and needs to be explored in future research studies. KEY POINTS: · Day of life is a critical factor in oral microbiome development in preterm infants.. · The oral microbiome may be associated with tracheal and gut microbiome colonization.. · Future research should examine sampling methodology for examining the oral microbiome.. · Future research should explore associations with the oral microbiome and adverse health outcomes..
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Affiliation(s)
- Rebecca Koerner
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida
| | - Marion M. Bendixen
- Department of Family, Community and Health System Science, University of Florida, Gainesville, Florida
| | - Angela Monk
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida
| | - Monica F.T. Lamberti
- Department of Microbiology and Cell Science University of Florida, Microbiology and Cell Science, Gainesville, Florida
| | - Graciela L. Lorca
- Department of Microbiology and Cell Science University of Florida, Microbiology and Cell Science, Gainesville, Florida
| | - Josef Neu
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Leslie A. Parker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida
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2
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Colombo SFG, Nava C, Castoldi F, Fabiano V, Meneghin F, Lista G, Cavigioli F. Preterm Infants' Airway Microbiome: A Scoping Review of the Current Evidence. Nutrients 2024; 16:465. [PMID: 38398790 PMCID: PMC10891673 DOI: 10.3390/nu16040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this scoping review was to investigate and synthesize existing evidence on the airway microbiome of preterm infants to outline the prognostic and therapeutic significance of these microbiomes within the preterm population and identify gaps in current knowledge, proposing avenues for future research. We performed a scoping review of the literature following the Arskey and O'Malley framework. In accordance with our inclusion criteria and the intended purpose of this scoping review, we identified a total of 21 articles. The investigation of the airway microbiome in preterm infants has revealed new insights into its unique characteristics, highlighting distinct dynamics when compared to term infants. Perinatal factors, such as the mode of delivery, chorioamnionitis, the respiratory support, and antibiotic treatment, could impact the composition of the airway microbiome. The 'gut-lung axis', examining the link between the lung and gut microbiome as well as modifications in respiratory microbiome across different sites and over time, has also been explored. Furthermore, correlations between the airway microbiome and adverse outcomes, such as bronchopulmonary dysplasia (BPD), have been established. Additional research in neonatal care is essential to understand the early colonization of infants' airways and explore methods for its optimization. The critical opportunity to shape long-term health through microbiome-mediated effects likely lies within the neonatal period.
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Affiliation(s)
- Sofia Fatima Giuseppina Colombo
- Department of Pediatrics, Buzzi Children’s Hospital, 20154 Milan, Italy; (S.F.G.C.); (C.N.)
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
| | - Chiara Nava
- Department of Pediatrics, Buzzi Children’s Hospital, 20154 Milan, Italy; (S.F.G.C.); (C.N.)
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
| | - Francesca Castoldi
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
| | - Valentina Fabiano
- Department of Pediatrics, Buzzi Children’s Hospital, 20154 Milan, Italy; (S.F.G.C.); (C.N.)
| | - Fabio Meneghin
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
| | - Gianluca Lista
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
| | - Francesco Cavigioli
- Division of Neonatology, Buzzi Children’s Hospital, 20154 Milan, Italy; (F.C.); (F.M.); (G.L.)
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Briere CE, Gomez J. Fresh Parent's Own Milk for Preterm Infants: Barriers and Future Opportunities. Nutrients 2024; 16:362. [PMID: 38337647 PMCID: PMC10857054 DOI: 10.3390/nu16030362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
While direct at-the-breast feeding is biologically optimal, Neonatal Intensive Care Unit (NICU) admission due to infant immaturity or illness often necessitates the expression and storage of parent's milk. The provision of freshly expressed (never stored) parent's own milk to preterm infants is not widely prioritized, and this article provides an exploration of NICU practices and their implications for feeding premature or ill infants with parent's own milk. In this article, we discuss the potential biological benefits of fresh parent's own milk, highlighting its dynamic components and the changes incurred during storage. Research suggests that fresh milk may offer health advantages over stored milk. The authors advocate for further research, emphasizing the need for standardized definitions. Research is needed on the biological impact of fresh milk, both short- and long-term, as well as defining and understanding healthcare economics when using fresh milk.
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Affiliation(s)
- Carrie-Ellen Briere
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
- Institute of Nursing Research and Evidence-Based Practice, Connecticut Children’s, Hartford, CT 06106, USA
| | - Jessica Gomez
- Department of Pediatrics/Neonatal-Perinatal Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
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Vanzele PAR, Sparvoli LG, de Camargo PP, Tragante CR, Beozzo GPNS, Krebs VLJ, Cortez RV, Taddei CR. Establishment of oral microbiome in very low birth weight infants during the first weeks of life and the impact of oral diet implementation. PLoS One 2023; 18:e0295962. [PMID: 38100452 PMCID: PMC10723731 DOI: 10.1371/journal.pone.0295962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
Very low birth weight (VLBW) infants, mostly preterm, have many barriers to feeding directly from the mother's breast, and need to be fed alternatively. Feeding is a major influencer in oral microbial colonization, and this colonization in early life is crucial for the promotion of human health. Therefore, this research aimed to observe the establishment of oral microbiome in VLBW infants during their first month of life through hospitalization, and to verify the impact caused by the implementation of oral diet on the colonization of these newborns. We included 23 newborns followed during hospitalization and analyzed saliva samples collected weekly, using 16S rRNA gene sequencing. We observed a significant decrease in richness and diversity and an increase in dominance over time (q-value < 0.05). The oral microbiome is highly dynamic during the first weeks of life, and beta diversity suggests a microbial succession in early life. The introduction of oral diet does not change the community structure, but affects the abundance, especially of Streptococcus. Our results indicate that although time is related to significant changes in the oral microbial profile, oral feeding benefits genera that will remain colonizers throughout the host's life.
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Affiliation(s)
- Pedro A. R. Vanzele
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Luiz Gustavo Sparvoli
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Patricia P. de Camargo
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Carla R. Tragante
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Glenda P. N. S. Beozzo
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Vera L. J. Krebs
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Ramon V. Cortez
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Carla R. Taddei
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
- School of Arts, Sciences and Humanity, University of São Paulo, São Paulo, SP, Brazil
- Division of Clinical Laboratory, University Hospital ‐ University of São Paulo, São Paulo, SP, Brazil
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Wang N, Zhang J, Yu Z, Yan X, Zhang L, Peng H, Chen C, Li R. Oropharyngeal administration of colostrum targeting gut microbiota and metabolites in very preterm infants: protocol for a multicenter randomized controlled trial. BMC Pediatr 2023; 23:508. [PMID: 37845612 PMCID: PMC10577906 DOI: 10.1186/s12887-023-04346-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Oropharyngeal administration of colostrum (OAC) has an immune-stimulating effect on oropharyngeal-associated lymphoid tissue, and can promote the maturation of the gastrointestinal tract. However, how OAC promotes intestinal maturation in preterm infants by altering gut microbiota remains unclear. We aim to assess changes in gut microbiota and metabolites after OAC in very preterm infants. METHODS A multicenter, double-blind, randomized controlled trial will be conducted in three large neonatal intensive care units in Shenzhen, China, with preterm infants with gestational age less than 32 weeks at birth and birth weight less than 1500 g. It is estimated that 320 preterm infants will be enrolled in this study within one year. The intervention group will receive oropharyngeal administration of 0.2 ml colostrum every 3 h, starting between the first 48 to 72 h and continued for 5 consecutive days. Following a similar administration scheme, the control group will receive oropharyngeal administration of sterile water. Stool samples will be collected at the first defecation, as well as on the 7th, 14th, 21st and 28th days after birth for analysis of effect of OAC on gut microbiota and metabolites through 16sRNA gene sequencing and liquid chromatography-mass spectrometry. DISCUSSION This proposal advocates for the promotion of OAC as a safe and relatively beneficial protocol in neonatal intensive care units, which may contribute to the establishment of a dominant intestinal flora. Findings of this study may help improve the health outcomes of preterm infants by establishment of targeted gut microbiota in future studies. TRIAL REGISTRATION NCT05481866 (registered July 30, 2022 on ClinicalTrials.gov).
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Affiliation(s)
- Na Wang
- Department of Neonatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Jia Zhang
- Department of Neonatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Zhangbin Yu
- Department of Neonatology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
| | - Xudong Yan
- Department of Neonatology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Lian Zhang
- Department of Neonatology, Bao'an Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Haibo Peng
- Department of Neonatology, Bao'an Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Cheng Chen
- Department of Neonatology, Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Rui Li
- Department of Neonatology, Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
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Arishi RA, Lai CT, Geddes DT, Stinson LF. Impact of breastfeeding and other early-life factors on the development of the oral microbiome. Front Microbiol 2023; 14:1236601. [PMID: 37744908 PMCID: PMC10513450 DOI: 10.3389/fmicb.2023.1236601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
The oral cavity is home to the second most diverse microbiome in the human body. This community contributes to both oral and systemic health. Acquisition and development of the oral microbiome is a dynamic process that occurs over early life; however, data regarding longitudinal assembly of the infant oral microbiome is scarce. While numerous factors have been associated with the composition of the infant oral microbiome, early feeding practices (breastfeeding and the introduction of solids) appear to be the strongest determinants of the infant oral microbiome. In the present review, we draw together data on the maternal, infant, and environmental factors linked to the composition of the infant oral microbiome, with a focus on early nutrition. Given evidence that breastfeeding powerfully shapes the infant oral microbiome, the review explores potential mechanisms through which human milk components, including microbes, metabolites, oligosaccharides, and antimicrobial proteins, may interact with and shape the infant oral microbiome. Infancy is a unique period for the oral microbiome. By enhancing our understanding of oral microbiome assembly in early life, we may better support both oral and systemic health throughout the lifespan.
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Affiliation(s)
- Roaa A. Arishi
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Ching T. Lai
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
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7
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Thatrimontrichai A, Surachat K, Singkhamanan K, Thongsuksai P. Long Duration of Oral Care Using Mother's Own Milk Influences Oral Microbiota and Clinical Outcomes in Very-low-birthweight Infants: Randomized Controlled Trial. Pediatr Infect Dis J 2023; 42:804-810. [PMID: 37343216 DOI: 10.1097/inf.0000000000004002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Several studies have focused on the clinical outcomes of oral care using colostrum for a limited time (2-5 days) in very-low-birthweight (VLBW) infants. However, the effect of long-term mother's own milk (MOM) on the clinical outcomes and oral microbiota of VLBW infants remains unknown. METHODS In this randomized controlled trial, VLBW neonates were randomly assigned to oral care by MOM or sterile water (SW) groups until they started oral feeding. The primary outcome was oral microbiota composition including alpha and beta diversity, relative abundance, and linear discriminant analysis effect size (LEfSe). The secondary outcomes were various morbidities and mortality. RESULTS The baseline characteristics of the two groups did not differ (63 neonates, MOM group, n = 30, oral care 22 days; SW group, n = 33, oral care 27 days). There was no significant difference in alpha and beta diversities between the groups before and after the intervention. The MOM group had a significantly lower rate of clinical sepsis than the SW group (47% vs. 76%, risk ratio = 0.62, 95% CI: 0.40-0.97). The relative abundance of Bifidobacterium bifidum and Faecalibacterium were maintained after MOM care, especially in neonates without clinical sepsis, but decreased after SW care. LEfSe showed that neonates in the MOM and SW groups with clinical sepsis had the highest abundance of Pseudomonas and Gammaproteobacteria, respectively, compared with neonates without sepsis. CONCLUSIONS A longer duration of oral care using MOM in VLBW infants sustains healthy bacteria and decreases the risk of clinical sepsis.
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Affiliation(s)
- Anucha Thatrimontrichai
- From the Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Komwit Surachat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Molecular Evolution and Computational Biology Research Unit, Prince of Songkla University, Songkhla, Thailand
| | - Kamonnut Singkhamanan
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Slouha E, Anderson ZS, Ankrah NMN, Kalloo AE, Gorantla VR. Colostrum and Preterm Babies: A Systematic Review. Cureus 2023; 15:e42021. [PMID: 37593258 PMCID: PMC10430891 DOI: 10.7759/cureus.42021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
Colostrum from mothers is rich in immunomodulating bio-factors such as immunoglobulins (IgA), lactoferrin, and oligosaccharides and supports gut microbial and inflammatory processes. The support in these processes may provide some relief for infants who are born pre-term. Pre-term infants are more likely to develop necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and ventilator-acquired/associated pneumonia (VAP). Due to the components of colostrum, there may be incentives towards early administration for preterm infants. An extensive literature review was done using ProQuest, ScienceDirect, and PubMed. Only meta-analyses and experimental studies were used. The search included the keywords 'colostrum and preterm' and 'colostrum and necrotizing enterocolitis'. The initial search generated 13,543 articles and was narrowed to 25 articles through comprehensive inclusion and exclusion criteria. There were significantly higher levels of Lactobacillus and Bifidobacterium in pre-term infants given colostrum and a decrease in Moraxellaceae and Staphylococcaceae. Salivary secretory IgA increased following oral colostrum administration in pre-term infants along with downregulation of interleukin (IL)-1b and IL-8. It was also observed that tumor necrosis factor (TNF)-a, and interferon-gamma (IFN-g) were significantly higher in the control group. There was no significant difference in the incidence of LOS, NEC, or VAP between pre-term infants receiving colostrum and those who did not. Secondary outcomes such as time to full enteral feeding were improved in pre-term infants receiving oral colostrum in addition to reduced hospital stays. Lastly, there was no difference in mortality between pre-term infants that received colostrum compared to those who did not.
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Affiliation(s)
- Ethan Slouha
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
| | - Zoe S Anderson
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
| | - Nana Mansa N Ankrah
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
| | - Amy E Kalloo
- Clinical Sciences, St. George's University School of Medicine, True Blue, GRD
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Pados BF. State of the Science on the Benefits of Human Milk for Hospitalized, Vulnerable Neonates. Nurs Womens Health 2023; 27:121-140. [PMID: 36871597 DOI: 10.1016/j.nwh.2023.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/16/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023]
Abstract
Research on human milk has increased dramatically in recent years. The purpose of this review is to describe the literature on the health benefits of human milk for hospitalized, vulnerable neonates. PubMed, CINAHL, and Embase were searched for research articles reporting the health outcomes of hospitalized neonates who were exposed to human milk. Human milk, particularly a mother's own milk, has the potential to reduce the risk of death and the risk and severity of necrotizing enterocolitis, infection, retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular hemorrhage, kidney disease, and liver disease. Dose and timing of human milk is important, with more human milk and earlier introduction having a greater impact on health. When a mother's own milk is not available, donor human milk provides benefits over infant formula.
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Association of Prematurity and Low Birth Weight with Gestational Exposure to PM 2.5 and PM 10 Particulate Matter in Chileans Newborns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106133. [PMID: 35627670 PMCID: PMC9142096 DOI: 10.3390/ijerph19106133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023]
Abstract
Fetal growth can be affected by gestational exposure to air pollution. The aim of the study was to determine the association between prematurity and low birth weight (LBW) with gestational exposure to PM2.5 and PM10 particulate matter in Chileans newborns. This cross-sectional analytical study included 595,369 newborns. Data were extracted from the live newborn records of the Chilean Ministry of Health. Sex, gestational age, birth weight, and living variables were analyzed. We used the Air Quality Information System of the Chilean Ministry of the Environment to obtain mean PM2.5 and PM10 emissions. A multivariate logistic regression model was performed with STATA 15.0 software at α < 0.05. Prevalence was 7.4% prematurity and 5.5% LBW. Mean PM2.5 and PM10 concentrations were 25.5 µg/m3 and 55.3 µg/m3, respectively. PM2.5 was associated with an increased the risk of LBW (OR: 1.031; 95%CI: 1.004−1.059) when exposure occurred in the second trimester, while PM10 affected the whole pregnancy. In addition, PM10 exposure in any gestational trimester was associated with an increased the risk of prematurity. The PM10 particulate matter was associated with both prematurity and LBW in all of the trimesters of exposure. The PM2.5 particulate matter was only associated with LBW when exposure occurred in the second gestational trimester.
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11
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Triarico S, Agresti P, Rinninella E, Mele MC, Romano A, Attinà G, Maurizi P, Mastrangelo S, Ruggiero A. Oral Microbiota during Childhood and Its Role in Chemotherapy-Induced Oral Mucositis in Children with Cancer. Pathogens 2022; 11:pathogens11040448. [PMID: 35456122 PMCID: PMC9025665 DOI: 10.3390/pathogens11040448] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
The human oral cavity harbors the second most abundant microbiota after the gastrointestinal tract, with over 700 species currently identified in the oral microflora. The oral microbiota develops from intrauterine life and after birth is continuously shaped by several influencing factors. The perturbation of the diversity and proportions of species within the oral microbiota leads to dysbiosis and associated increased risk of local and systemic diseases. In children who receive chemotherapy for cancer, oral mucositis is a common and painful side effect that decreases quality of life (QoL) and treatment adherence. The oral microbiota undergoes a substantial dysbiosis as an effect of cancer and its treatment, characterized by lower richness and less diversity. Furthermore, this dysbiosis seems to promote pro-inflammatory cytokine release and pro-apoptotic mediators, enhancing the oral tissue damage. Further studies on the role of the oral microbiota in the pathogenesis of oral mucositis should be performed among children with cancer who receive chemotherapy, to find preventive and protective factors against the pathogenesis of oral mucositis.
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Affiliation(s)
- Silvia Triarico
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
| | - Pierpaolo Agresti
- Scuola di Specializzazione in Pediatria, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy;
| | - Emanuele Rinninella
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (E.R.); (M.C.M.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy
| | - Maria Cristina Mele
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (E.R.); (M.C.M.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy
| | - Alberto Romano
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
| | - Giorgio Attinà
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
| | - Palma Maurizi
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy
| | - Stefano Mastrangelo
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy
| | - Antonio Ruggiero
- UOSD di Oncologia Pediatrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Argo A. Gemelli 8, 00168 Rome, Italy; (S.T.); (A.R.); (G.A.); (P.M.); (S.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Largo F.sco Vito 1, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-3058203; Fax: +39-06-3052751
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Huo M, Liu C, Mei H, Zhang Y, Liu C, Song D, Zhang Y, Zhang Y, Xin C. Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis. Front Pediatr 2022; 10:895375. [PMID: 35832583 PMCID: PMC9271762 DOI: 10.3389/fped.2022.895375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of oropharyngeal administration of colostrum (OAC) in preterm infants. METHODS We searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the website of the clinical trials, search time was from the establishment of the databases or websites up to 1 February 2022. Preterm infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) ≤ 1500 g were taken as the participants, collect randomized controlled trials (RCTs) of comparing OAC and placebo or no intervention in preterm infants. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature, and we adopted Review Manager 5.3 software for meta-analysis. RESULTS In total, 11 RCTs (n = 1,173) were included in the review. A meta-analysis showed significant difference in the incidence of necrotizing enterocolitis [NEC; p = 0.009, relative ratio (RR) = 0.51, 95% confidence interval (CI) = 0.31-0.84], late-onset sepsis (LOS; p = 0.02, RR = 0.75, 95% CI = 0.59-0.95), ventilator-associated pneumonia (VAP; p = 0.03, RR = 0.48, 95% CI = 0.24-0.95), the time to reach full enteral feeds (p < 0.00001, mean difference (MD) = -3.40, 95% CI = -3.87 to -2.92), duration of hospital stay (p < 0.00001, MD = -10.00, 95% CI = -11.36 to -8.64), and the rate of weight gain (kg.d; p < 0.00001, MD = 2.63, 95% CI = 2.10-3.16) between the colostrum group and control group. Meanwhile, researchers found no significant difference between the colostrum group and control group in the incidence of bronchopulmonary dysplasia (BPD; p = 0.17, RR = 0.83, 95% CI = 0.64-1.08), intraventricular hemorrhage (IVH; grade ≥3; p = 0.05, RR = 0.44, 95% CI = 0.19-1.01), periventricular leukomalacia (PVL; p = 0.67, RR = 0.70, 95% CI = 0.14-3.49), retinopathy of prematurity (ROP; p = 0.29, RR = 1.25, 95% CI = 0.82-1.89), and patent ductus arteriosus (PDA; p = 0.17, RR = 1.22, 95% CI = 0.92-1.62). CONCLUSION Oropharyngeal administration of colostrum can reduce the incidence of NEC, LOS, and VAP in preterm infants, shortening the time to reach full enteral feeds, and duration of hospital stay, and increasing the rate of weight gain (kg.d). Therefore, OAC can be used as part of routine care for preterm infants.
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Affiliation(s)
- Mengyue Huo
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Chunli Liu
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Hua Mei
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Yuheng Zhang
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Chunzhi Liu
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Dan Song
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Yayu Zhang
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Yanbo Zhang
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Chun Xin
- Department of Neonatology, Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
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