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Premature birth (prematurity) affects 1.5% of children and is the leading cause of infant mortality in the world. Thanks to intensive scientific research, the treatment and survival of preterm infants has greatly improved in recent years and children born more than 3 months premature can survive. Due to immaturity of the immune system and organs, a large proportion of these children have serious health problems in the first weeks of their life, such as blood poisoning (sepsis) and severe inflammation of the intestines (necrotizing entrocolitis, NEC), from which many of these premature infants die every year.

In recent years, it has become clear that the bacteria in the gut (microbiome) play an important role in the development of these diseases, as well as in health later in life. A balanced development of the microbiome is therefore extremely important. That is why more and more intensive care units are also giving prebiotics. Probiotics can promote the growth of good bacteria in the gut. However, many other drugs can seriously disrupt the balance of gut bacteria, actually increasing the risk of serious illness. For example, antibiotics administered to almost all preterm infants can kill not only harmful, but also many good, protective bacteria. This disruption of the microbiome increases the risk of NEC and sepsis. In addition, a disrupted microbiome is associated with diseases later in life, such as developmental delays, growth problems, asthma, allergy and autoimmune diseases.

Researches at Emma Children’s Hospital will investigate the effects of antibiotics, a disrupted microbiome in the GENERATION P study. All children born prematurely in the Netherlands will be able to participate. Research into the relationship between medication use, the microbiome and long term health effects may lead to new treatments to protect and improve the microbiome to improve both early and late outcomes for this vulnerable group of children.