Comparisons of fecal microbiota and cytokines in preterm infants preceding necrotizing enterocolitis and feeding intolerance: An observational study

To facilitate earlier detection of necrotizing enterocolitis (NEC), we compared serum cytokines and fecal microbiota composition in preterm infants prior to the occurrence of NEC, with those exhibiting feeding intolerance (FI) or unaffected controls. Fecal microbiota and early serum cytokines in preterm infants were analyzed and compared. The gestational age (GA) at birth and birth weight did not differ among the groups, averaging 29.5 weeks and 1289.0 g, respectively. Respiratory distress syndrome (RDS, P = .010) and intraventricular hemorrhage (P = .047) were more commonly observed in the NEC group compared to others. There were no significant differences in the serum concentrations of various cytokines among the 3 groups. Individual variability in fecal microbial compositions was noted. No significant differences were observed in the alpha and beta diversities in fecal microbiota among the groups. TNFα showed a negative correlation with the abundant microbiota in feces of preterm infants. Rather than early intestinal dysbiosis or alterations in serum cytokines, meticulous monitoring for signs in preterm infants experienced clinical instability in early transitional period remains crucial for timely diagnosis of NEC. Serum cytokines may be associated with the development of gut microbiota in preterm infants, suggesting the need for further comprehensive study.