584 - Maternal Factors Associated with the Delivery of Preterm Infants Admitted to the Neonatal Intensive Care Unit

Poster Number: 584
Publication Number: 584.241

Mary Clare Lipa, Loyola University Chicago Stritch School of Medicine, Naperville, IL, United States; Emily Flammersfeld, Loyola University Chicago Stritch School of Medicine, Oswego, IL, United States; Kaavya Adam, CHLA, Orange, CA, United States; Julia Organ, Loyola University Chicago Stritch School of Medicine, Oak Park, IL, United States; Candice Choo-Kang, Loyola University Chicago Stritch School of Medicine, Chicago, IL, United States; Gertrude Ecklu-Mensah, University of California, San Diego School of Medicine, La Jolla, CA, United States; Sachin Amin, Loyola University Chicago Stritch School of Medicine, Maywood, IL, United States; Bridget Boyd, Loyola University Chicago Stritch School of Medicine, Maywood, IL, United States; Lara Dugas, Loyola University Chicago, Maywood, IL, United States

Background: Inadequate infant gut microbiota colonization may predispose infants to the development of atopic and metabolic diseases like asthma and obesity. Preterm infants may be particularly at risk because of altered feeding patterns and hospitalization. Furthermore, the influence of mother-to-child vertical microbial transmission has not been explored in preterm infants.

Objective: The objective of this study was to explore maternal factors that may influence microbial colonization in preterm infants at Loyola University Medical Center (LUMC).

Design/Methods: Mothers of preterm infants admitted to the Neonatal Intensive Care Unit at LUMC between July 2018 and March 2020 were included in the current cohort analysis. Data were collected by retrospective chart review of maternal socio-demographic factors and health outcomes, including maternal gestational weight gain (GWG), and are presented as median (interquartile range) and frequencies. Multiple linear regression and Chi-square test were used to explore associations between GWG, socio-demographic factors, and maternal health. Preterm infants had stool samples collected for microbiota analysis. Differences between GWG categories in mean alpha diversity were assessed using the Kruskal-Wallis test, and PERMANOVA tests were used for differences in beta diversity.

Results: The study population included 27 mothers of 34 preterm infants. Maternal age was 34 (25-36) years and gestational age was 30 (26-31) weeks. Approximately 88.9% received prenatal care and 77.8% delivered via Cesarean section. More than half (74.1%) lived in a low-poverty area. Most participants identified as white (59.3%) and of non-Hispanic origin (63.0%). Pre-pregnancy maternal BMI was 25.5 (24.7-32.3). Overall, 18.5% of mothers had inadequate GWG, 14.8% had adequate GWG, and 33.3% had excess GWG. Mothers with inadequate GWG were younger than mothers with adequate GWG (25 years vs. 36 years, p=0.06). Additionally, mothers with inadequate GWG lived in low poverty areas, and mothers with adequate GWG tended to not have chronic or develop gestational hypertension. Finally, microbial diversity of the preterm infant gut microbiota varied by maternal gestational weight gain status, although there were no significant differences in alpha or beta diversity.Conclusion(s): Maternal GWG may be impacted by age and poverty, which may alter both pregnancy health outcomes and preterm infant gut microbiota colonization. This finding provides preliminary evidence for future studies to explore the impact of maternal factors on preterm infant gut microbiota colonization and child health outcomes.
Maternal Body Mass Index and Gestational Weight Gain CategoriesGraph of the number of mothers in the BMI categories of normal weight, overweight, and obesity who had inadequate, adequate, or excess gestational weight gain.
Maternal Demographics and Health OutcomesTable of maternal socio-demographic factors and health outcomes for all mothers in the current analysis separated by maternal gestational weight gain (GWG) categories. Percentages in GWG category columns reflect frequency within mothers whose GWG was calculated. * indicates p < 0.1.