Contributors to Dysbiosis in Very-Low-Birth-Weight Infants

J Obstet Gynecol Neonatal Nurs. 2020 May;49(3):232-242. doi: 10.1016/j.jogn.2020.02.003. Epub 2020 Apr 2.


The objective of this commentary was to analyze the causes and outcomes of gut microbiome dysbiosis in preterm infants who are born at very low birth weight (VLBW). The intrauterine development of VLBW infants is interrupted abruptly with preterm birth and followed by extrauterine, health-threatening conditions and sequelae. These infants develop intestinal microbial dysbiosis characterized by low diversity, an overall reduction in beneficial and/or commensal bacteria, and enrichment of opportunistic pathogens of the Gammaproteobacteria class. The origin of VLBW infant dysbiosis is not well understood and is likely the result of a combination of immaturity and medical care. We propose that these factors interact to produce inflammation in the gut, which further perpetuates dysbiosis. Understanding the sources of dysbiosis could result in interventions to reduce gut inflammation, decrease enteric pathology, and improve health outcomes for these vulnerable infants.

Keywords: dysbiosis; gut microbiome; health; prematurity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Dysbiosis / etiology*
  • Dysbiosis / physiopathology
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight / metabolism
  • Infant, Very Low Birth Weight / physiology*
  • Intensive Care Units, Neonatal
  • Iron / administration & dosage
  • Iron / adverse effects
  • Iron / therapeutic use
  • Milk, Human / metabolism*
  • Stress, Physiological


  • Anti-Bacterial Agents
  • Iron