Association between the gut microbiome and neurodevelopmental outcomes in infants with congenital heart disease: A prospective cohort study
Abstract
Background
Children with congenital heart disease are at risk for poor neurodevelopment. The gut microbiome may influence neurodevelopmental outcomes through the gut-brain axis. This study investigated the association of early-life gut microbiome with neurodevelopmental outcomes.
Methods
A prospective cohort study was conducted in the cardiac intensive care unit. Fecal samples were collected before surgery, after surgery, and before discharge. Neurodevelopmental testing used Bayley Scales of Infant and Toddler Development between 9 and 12 months. Microbial data of the 16S ribosomal RNA V4 region were processed. Microbiome data were analyzed using Quantitative Insights Into Microbial Ecology 2 and MicrobiomeAnalyst 2.0.
Results
Twenty-four patients were analyzed: 15 (62.5%) were male and 12 (50%) were White. Children with lower cognitive (Chao1 P = 0.024) and language scores (Chao1 P = 0.018) had lower alpha diversity; beta diversity showed marginally significant dissimilarities (Jaccard P = 0.102 and P = 0.051, respectively). Lower cognitive scores were associated with less Parabacteroides (P = 0.031), Bacteroides (P = 0.041), and Bifidobacterium (P = 0.047), and lower language scores were associated with less Bifidobacterium (P = 0.044) and Enterococcus (P = 0.024). Lower motor scores were associated with less Rothia (P = 0.017) but a higher abundance of Serratia (P < 0.001), Acinetobacter (P = 0.016), and Proteus (P = 0.013).
Conclusion
Children with congenital heart disease with lower cognitive and language scores had lower diversity and less anti-inflammatory flora (eg, Bifidobacterium), whereas those with lower motor scores had a higher abundance of pro-inflammatory flora (eg, Serratia, Acinetobacter, and Proteus). Further studies are needed to understand the longitudinal effect of gut microbial dysbiosis on neurodevelopment in children with congenital heart disease.