The impact of iron supplementation on the preterm neonatal gut microbiome: A pilot study

Matthew VanOrmer, Maranda Thompson, Melissa Thoene, Jean Jack Riethoven, Sathish Kumar Natarajan, Corrine Hanson, Ann Anderson-Berr

Research output: Contribution to journalArticlepeer-review


Objective The gastrointestinal microbiome in preterm infants exhibits significant influence on optimal outcomes-with dysbiosis shown to substantially increase the risk of the life-threatening necrotizing enterocolitis. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurodevelopment. However, excess colonic iron exhibits potent oxidation capacity and alters the gut microbiome-potentially facilitating the proliferation of pathological bacterial strains. Breastfed preterm infants routinely receive iron supplementation starting 14 days after delivery and are highly vulnerable to morbidities associated with gastrointestinal dysbiosis. Therefore, we set out to determine if routine iron supplementation alters the preterm gut microbiome. Methods After IRB approval, we collected stool specimens from 14 infants born <34 weeks gestation in the first, second, and fourth week of life to assess gut microbiome composition via 16S rRNA sequencing. Results We observed no significant differences in either phyla or key genera relative abundance between pre- and post-iron timepoints. We observed notable shifts in infant microbiome composition based on season of delivery. Conclusion Though no obvious indication of iron-induced dysbiosis was observed in this unique study in the setting of prematurity, further investigation in a larger sample is warranted to fully understand iron's impact on the gastrointestinal milieu.

Original languageEnglish (US)
Article numbere0297558
JournalPloS one
Issue number2 FEBRUARY
StatePublished - Feb 2024

ASJC Scopus subject areas

  • General


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