Abstract

There is controversy about the changes of intestinal and respiratory microbiota characteristics in patients with bronchopulmonary dysplasia and some studies have reported inconsistent or even contrary results. We performed a meta-analysis to explore the characteristics of the respiratory tract and gut microbiota in preterm infants with bronchopulmonary dysplasia. A complete search of the database (last updated on September 1, 2023) was conducted based on the preferred reporting project statement for systematic review and meta-analysis to identify eligible case-control studies that tested the gut and respiratory tract microbiota of patients with bronchopulmonary dysplasia. The results of meta-analysis were expressed as effect size and 95 % confidence interval. The bias control was assessed using Newcastle-Ottawa scale and funnel plot analysis. Seven studies (Newcastle-Ottawa scale score range from 6-8) were included, three studies (n=76, observation group n=36/control group n=40) collected intestinal microbial samples, and four studies (n=98, observation group n=46/control group n=52) collected respiratory tract microbial samples. The results showed that the richness and diversity of respiratory tract and intestinal microbial communities were decreased in bronchopulmonary dysplasia patients. In this meta-analysis, we analyzed the characteristics of respiratory tract and intestinal microbiota in premature infants with bronchopulmonary dysplasia, and found that the abundance and diversity of respiratory tract and intestinal microbiota in bronchopulmonary dysplasia patients were reduced. The intestinal microflora of Firmicutes, Actinobacteria, Veillonella and Escherichia/ Shigella in premature infants with bronchopulmonary dysplasia increased. Proteobacteria, Bacteroidetes, Cyanobacteria, Enterococcus, Enterobacteriaceae and Streptococcus were reduced. Firmicutes increased in the respiratory tract of premature infants with bronchopulmonary dysplasia, while Proteobacteria, Bacteroidetes and Cyanobacteria decreased. In addition, the characteristics of respiratory microbiome in premature infants with bronchopulmonary dysplasia may be affected by region or race.