The goal of this clinical trial is to understand the impact of respiratory microbiome maturation in respiratory health of preterm infants under 32 gestational weeks. The main questions it aims to answer are: * What is the role of microbiome maturation in respiratory health (development of bronchopulmonary dysplasia, childhood asthma and viral respiratory infections) of preterm infants ? * Which environmental or health factors are involved in the maturation of the respiratory microbiome ? Participants will undergo follow-up from birth until 3 years of corrected age including nasal swabs, stool samples, and for some of them blood and milk sample.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
270
Nasal swab is performed by nurses at birth (within 72 hours), and each week during initial neonatal care unit stay. After discharge, nasal swabs will be performed by parents at home and sent by post to the investigational center.
For 50-60 patients: 1 mL of blood sampling will be performed once during current care blood test (without additional blood draw), around 36 gestational weeks (+/- 1 week).
For 50-60 patients: 1 mL of mother milk will be sampled once during hospital stay in case of breastfeeding.
Stool sampling will occure at birth (within 72 hours after birth), then once a week during neonatal unit stay.
Service de néonatalogie, CHU d'Amiens
Amiens, France
Service de néonatalogie, CHU de Caen
Caen, France
Service de néonatalogie, CH Cherbourg-en-Cotentin
Cherbourg, France
Service de néonatalogie, GHT du Havre
Le Havre, France
Service de néonatalogie, CHRU de Lille
Lille, France
Service de néonatalogie, CHU de Rouen
Rouen, France
Diagnosis of bronchopulmonary dysplasia
At 36 gestational weeks, bronchopulmonary dysplasia (BPD) will be retained if any ventilatory support (invasive, non invasive, high or low flow oxygen) is required at least 23h over 24. This definition is based on the Jobe 2001 criteria for BPD diagnosis moderate or severe.
Time frame: 36 gestational weeks
Multidimensional analysis of microbiome profiles
From metatranscriptomics analysis of nasal swabs, the following informations will be computed: most abundant species, diversity indexes, clustering, relative abundance of pathobionts, expressed functions, metabolic pathways activated, principal component analysis, linear differencial analysis and effect size. Also the RNA host expression in particular inate immunity, metabolic and inflammatory pathways.
Time frame: At birth, 32 GW (gestational weeks), 36 GW and 4 months of corrected age.
Bronchopulmonary dysplasia severity
According to the ventilatory support and oxygenation level required at 36 gestational weeks, BPD severity will be defined accordind to Higgings 2018 criteria.
Time frame: 36 gestational weeks
Viral detection
At each timepoint, metatranscriptomic approach may identify a virus into the nasal swabs.
Time frame: At birth, 32 GW (gestational weeks), 36 GW and 4 months of corrected age.
Viral infections or bronchiolitis during childhood
Parents will answer short questionnaires to assess the occurence of viral respiratory infections or bronchiolitis for their infant after discharge.
Time frame: 1, 2, 4, 8, 12, 18, 24 and 36 months of corrected age.
Preschool asthma
The existence of preschool asthma (diagnosed or described by symptoms), will be search at 12, 18, 24, and 36 months by parental questionnaire.
Time frame: Up to 36 months of corrected age.
Cellular RNA expression in peripherical blood
For a subgroup of 50-60 patients, single cell RNA sequencing of peripherical blood mononuclear cells will be performed to assess the immune / inflammatory status of patients.
Time frame: 36 gestational weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.