Maternal diet during pregnancy and intestinal markers are associated with early gut microbiota.

BACKGROUND: Diet has an important role in host-microbiome interplay, which may result in intestinal permeability changes and physiopathological effects at a systemic level. Despite the importance of maternal microbiota as the main contributor to the initial microbial seeding, little is known about the effects of maternal diet during pregnancy on maternal-neonatal microbiota. OBJECTIVES: This study aimed at ascertaining the possible associations between maternal dietary intake during pregnancy and neonatal microbiota at birth and to evaluate the relationship with maternal intestinal markers. METHODS: In a nested cross-sectional study in the longitudinal MAMI cohort, maternal-neonatal microbiota profiling at birth (n = 73) was assessed by 16S rRNA gene sequencing. Maternal intestinal markers as zonulin, intestinal alkaline phosphatase (IAP) activity and faecal calprotectin were measured in faeces. Furthermore, maternal-neonatal clinical and anthropometric data, as well as maternal nutrient intake during pregnancy obtained by FFQ questionnaires, were collected. RESULTS: Maternal diet is associated with both maternal and neonatal microbiota at the time of birth, in a delivery mode-dependent manner. The existing link between maternal diet, intestinal makers and neonatal gut microbiota would be mainly influenced by the intake of saturated (SFA) and monounsaturated fatty acids (MUFA). Members of Firmicutes in the neonatal microbiota were positively associated with maternal fat intake, especially SFA and MUFA, and negatively correlated to fibre, proteins from vegetable sources and vitamins. CONCLUSIONS: Maternal diet during pregnancy, mainly fat intake (SFA and MUFA), was related to intestinal markers, thus likely shifting the microbial transmission to the neonate and priming the neonatal microbial profile with potential health outcomes. CLINICAL TRIAL REGISTRY: NCT03552939.

Perinatal environment shapes microbiota colonization and infant growth: impact on host response and intestinal function.

BACKGROUND: Early microbial colonization triggers processes that result in intestinal maturation and immune priming. Perinatal factors, especially those associated with birth, including both mode and place of delivery are critical to shaping the infant gut microbiota with potential health consequences. METHODS: Gut microbiota profile of 180 healthy infants (n = 23 born at home and n = 157 born in hospital, 41.7% via cesarean section [CS]) was analyzed by 16S rRNA gene sequencing at birth, 7 days, and 1 month of life. Breastfeeding habits and infant clinical data, including length, weight, and antibiotic exposure, were collected up to 18 months of life. Long-term personalized in vitro models of the intestinal epithelium and innate immune system were used to assess the link between gut microbiota composition, intestinal function, and immune response. RESULTS: Microbiota profiles were shaped by the place and mode of delivery, and they had a distinct biological impact on the immune response and intestinal function in epithelial/immune cell models. Bacteroidetes and Bifidobacterium genus were decreased in C-section infants, who showed higher z-scores BMI and W/L during the first 18 months of life. Intestinal simulated epithelium had a stronger epithelial barrier function and intestinal maturation, alongside a higher immunological response (TLR4 route activation and pro-inflammatory cytokine release), when exposed to home-birth fecal supernatants, compared with CS. Distinct host response could be associated with different microbiota profiles. CONCLUSIONS: Mode and place of birth influence the neonatal gut microbiota, likely shaping its interplay with the host through the maturation of the intestinal epithelium, regulation of the intestinal epithelial barrier, and control of the innate immune system during early life, which can affect the phenotypic responses linked to metabolic processes in infants. TRIAL REGISTRATION: NCT03552939 . Video Abstract.

Los neonatos también tienen gripe / Neonates also have flu

INTRODUCCIÓN: Los niños son la población de mayor incidencia de gripe y la principal fuente de transmisión de la enfermedad. Sin embargo, hay pocos casos reportados y poca información sobre el manejo en la edad neonatal, población especialmente vulnerable. El objetivo de este estudio es describir los casos de gripe en neonatos ingresados en un hospital terciario, comparando el manejo con otros centros descritos en la literatura. MATERIAL Y MÉTODOS: Presentamos un estudio descriptivo, longitudinal y retrospectivo de casos de gripe neonatal entre 2009 y 2019 en una unidad nivel III en neonatología. Se han estudiado variables epidemiológicas, clínicas, diagnósticas, pronósticas y terapéuticas de interés. RESULTADOS: Se estudiaron un total de 13 casos. Se encontró ambiente epidémico familiar en el 61,5% de los pacientes. La infección respiratoria superior y las desaturaciones fueron los síntomas más prevalentes (69,2%). El virus más frecuentemente aislado fue el de la Gripe A tipo H1N1 (69,2%). El 61,5% se trataron con antibioterapia y dos (15,4%) recibieron tratamiento con oseltamivir. El 46,1% de los casos precisó ingreso en Unidad de Cuidados Intensivos Neonatales y soporte ventilatorio, pero no se registró ningún éxitus. CONCLUSIONES: La población neonatal es especialmente vulnerable a la gripe y sus complicaciones, requiriendo con frecuencia ingreso en las unidades de cuidados intensivos. Evitar el ambiente epidémico es un arma importante en la prevención. Dado que es una patología infrecuente en este grupo de edad, existe escasa evidencia sobre su adecuado manejo, por lo que consideramos necesarios más estudios para optimizar su tratamiento y soporte

INTRODUCTION: Children are the population with the biggest flu incidence and the main source of transmission of this illness. However, there are few cases reported and few information regarding it management in neonates, a very vulnerable population. The aim of this study is describing flu neonatal cases admitted in a tertiary care hospital and comparing it management with other centres described in the literature. MATERIAL AND METHODS: We present a descriptive, longitudinal and retrospective study of flu neonatal cases between 2009 and 2019 in the Unit of Neonatology in a tertiary care hospital. Epidemiological, clinical, diagnostic, prognostic and therapeutic variables of interest have been studied. RESULTS: 13 cases were studied. Family epidemic environment was found in 61.5% of patients. Upper respiratory infection and desaturations were the most prevalent symptoms (69.2%). The most frequently isolated virus was Influenza A type H1N1 (69.2%). 61.5% were treated with antibiotherapy and two cases (15.4%) with oseltamivir. 46.1% of cases required admission to the Neonatal Intensive Care Unit and ventilatory support, but no exitus was recorded. CONCLUSIONS: Neonatal population is especially vulnerable to flu and its complications, often requiring admission to Intensive Care Units. Avoiding the epidemic environment is an important prevention weapon. Given that it is an infrequent pathology in this age group, there is little evidence about its proper management, so we consider that more studies are necessary for its treatment and support

Lesión cerebral transitoria en convulsión afebril por rotavirus / Transient cerebral lesion in an afebrile seizure due to rotavirus

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