{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:27:56Z","timestamp":1785252476973,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    Preterm birth is a leading global cause of neurodevelopmental impairment (NDI), yet early predictive biomarkers remain elusive. The gut microbiome, developing in parallel with the brain and communicating via the microbiota-gut-brain axis, holds potential as a source of such biomarkers. However, specific longitudinal multi-omics signatures predictive of NDI risk in preterm infants are poorly defined. We conducted a prospective, matched, longitudinal study of 60 preterm infants, classified at 3 months corrected age (CA) into high-risk (HR, n=30) or low-risk (LR, n=30) groups for NDI based on combined motor (TIMP) and neurological (GMs) assessments. Fecal samples from birth (meconium) and 3 months CA underwent shotgun metagenomic sequencing and untargeted metabolomics. Groups were rigorously matched for gestational age, birth weight, sex, and clinical exposures. While \u03b1- and \u03b2-diversity did not differ between groups, profound taxonomic and functional divergence emerged. At 3 months CA, the LR gut was enriched with\n                    <jats:italic>Akkermansia muciniphila<\/jats:italic>\n                    , whereas the HR gut was dominated by\n                    <jats:italic>Klebsiella variicola<\/jats:italic>\n                    . Functional metagenomics revealed a dysbiotic HR trajectory, enriching pathways for bacterial virulence, stress response, and\u2014notably\u2014multiple pathways annotated for human neurodegenerative diseases, contrasting with LR expansion of core biosynthesis. Metabolomics confirmed a dysfunctional HR state, showing impaired amino acid metabolism and aberrant neuroactive pathway enrichment. Critically, meconium features correlated with 3-month neurobehavioral scores, demonstrating ultra-early predictive potential. Integrated networks at 3 months directly linked\n                    <jats:italic>Akkermansia muciniphila<\/jats:italic>\n                    and co-varying glycerophospholipids to superior neurodevelopmental scores, forming a beneficial \u201c\n                    <jats:italic>Akkermansia<\/jats:italic>\n                    -lipid\u201d axis, while\n                    <jats:italic>Klebsiella variicola<\/jats:italic>\n                    and triterpenoids formed a dysbiotic hub. Our study defines a high-risk gut ecosystem trajectory in preterm infants, characterized by early commensal depletion, pathobiont expansion, and a functional shift towards inflammation and neuroinflammation. These signatures offer novel targets for early risk prediction and microbiome-targeted interventions.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2026.1799859","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:34:03Z","timestamp":1775540043000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Gut microbiota and metabolome signatures in preterm infants with high versus low risk for neurodevelopmental impairment: a prospective, matched, longitudinal multi-omics study"],"prefix":"10.3389","volume":"16","author":[{"given":"Yan-ping","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine (Pediatric Rehabilitation Division), Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Clinical College of Shantou University Medical College)","place":["Shenzhen, 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