Table 1_Preterm birth alters the gut microbiota, metabolome and health outcomes of twins at 12 months of age.xlsx

IntroductionPerinatal factors affect gut microbiota and infant health, but the combined impacts of preterm birth and chorionicity on gut microbiota, metabolism, and physical/neurobehavioral development in twins remain unclear.
MethodsA total of 143 twin families (12-month-old infants) were enrolled and divided into four groups by gestational age and chorionicity (dichorionic-diamniotic full-term/preterm, monochorionic-diamniotic full-term/preterm). Gut microbiota diversity and fecal metabolism were analyzed via 16S rRNA sequencing and untargeted metabolomics. Wilcoxon’s rank-sum tests, generalized estimating equations, and twin-based ACE models were used for alpha diversity comparison, differential microbiota identification, and genetic/environmental contribution evaluation, respectively, with confounder adjustment in development association analysis.
ResultsWe identified 10 group-specific gut microbiota genera and 394 differential metabolites. Fifty-two microbiota taxa showed genetic variance, but none overlapped with group-specified taxa. Six genera and 18 metabolites correlated with twins’ physical/neurobehavioral development. Pathway analysis highlighted three key metabolites: Morphine (isoquinoline alkaloid biosynthesis, drug metabolism, neuroactive ligand-receptor interaction), Nicotinuric acid (nicotinate/nicotinamide metabolism), and Catechin (flavonoid/phenylpropanoid biosynthesis).
DiscussionPreterm birth is linked to gut microbiota dysbiosis and metabolic perturbations, which may affect twin development. Notably, preterm birth exerts a stronger effect than genetic factors in shaping the gut microbiota of 12-month-old twins.