From microbes to milestones: Gut bacterial abundances and functional pathways associate with neurodevelopment following preterm birth.

Overview

1. Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
2. Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
3. Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
4. Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
5. Simpson Centre for Reproductive Health, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
6. Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital and University Medical Center Utrecht, Utrecht, the Netherlands

Abstract

The early life gut microbiome has been identified as a potential driver of neurocognitive development. Evidence for this relationship in preterm children, who are at increased risk of both gut microbiome disruptions and neurodevelopmental impairment, is scarce. In a sample of 73 very preterm infants drawn from a prospective birth cohort, we assessed associations between the neonatal gut microbiome and neurodevelopmental outcomes at 9 months and 2 years. The gut microbiome taxonomic and functional profiles were obtained from stool samples collected prior to NICU discharge using shotgun metagenomics. Neurodevelopment was assessed using a battery of outcome measures. We took a consensus-based analytic approach, applying several different methods to investigate microbiome-outcome relationships and focussing on results which were consistently significant across methods. We found the most robust evidence for associations between the abundances of several gut bacterial species and measures related to autistic traits (e.g. Klebsiella spp.), socio-emotional development, including temperament (e.g. Enterobacter cloacae complex, Veillonella parvula), and executive functioning (Clostridium perfringens). The abundances of functional modules involved in gut-brain signalling, particularly those involved in histamine and quinolinic acid metabolism, were associated with outcome measures related to executive functioning and cognitive-behavioural flexibility. This study provides evidence that the neonatal gut microbiome composition may affect longer-term neurodevelopmental profiles following preterm birth, particularly those related to socio-emotional development, autistic traits and executive functioning.

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Data

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Data availability

Data are deposited in Edinburgh Data Vault; access is considered under the study’s Data Access and Collaboration policy. Analysis code is available on GitLab. Details are provided in the main text.

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Version 2, 28 September 2026

• Publisher: n/a → Elsevier BV
• Authors: added Kadi Vaher (0000-0002-0733-2505); removed Kadi Vaher

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, pages, dates, 12 authors, 7 keywords, 2 funders, 135 references.

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This paper

Vaher, K., Kenny, A., Lusarreta Parga, P., Jiménez-Sánchez, L., Turner, H., Smikle, R., Corrigan, A., Cruickshank, H., Rudnicka, M., Fletcher-Watson, S., Bogaert, D., & Boardman, J. P. (2026). From microbes to milestones: Gut bacterial abundances and functional pathways associate with neurodevelopment following preterm birth. Gut microbiology, 2, None. https://doi.org/10.1016/j.gutmic.2026.100006

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