Table 1. Associations Between Cluster of Microbiota, Neonatal Characteristics, Individual Therapies, and NICU Strategies.
| Variable | Cluster, No./No. (%)a | P value | |||||
|---|---|---|---|---|---|---|---|
| 1 (n = 240) | 2 (n = 68) | 3 (n = 61) | 4 (n = 63) | 5 (n = 52) | 6 (n = 93) | ||
| Gestational age, wk | |||||||
| 24-26 | 33/240 (10.6) | 8/68 (9.0) | 6/61 (7.5) | 20/63 (25.7) | 31/52 (52.3) | 47/93 (43.1) | <.001 |
| 27-29 | 101/240 (43.6) | 25/68 (37.9) | 16/61 (26.9) | 32/63 (55.3) | 17/52 (38.6) | 35/93 (43.3) | |
| 30-31 | 106/240 (45.8) | 35/68 (53.1) | 39/61 (65.6) | 11/63 (19.0) | 4/52 (9.1) | 11/93 (13.6) | |
| Maternal age, y | |||||||
| <25 | 38/240 (16.0) | 6/68 (9.1) | 10/61 (16.0) | 17/63 (26.7) | 10/52 (19.2) | 15/93 (16.6) | .03 |
| 25-34 | 136/240 (56.7) | 49/68 (71.2) | 43/61 (70.6) | 35/63 (56.9) | 31/52 (59.3) | 48/93 (51.1) | |
| >35 | 66/240 (27.3) | 13/68 (19.7) | 8/61 (13.5) | 11/63 (16.3) | 11/52 (21.5) | 30/93 (32.3) | |
| Country of birth of the mother | |||||||
| France | 174/237 (73.0) | 46/68 (67.8) | 51/61 (83.6) | 48/63 (75.4) | 32/52 (63.3) | 69/93 (74.5) | .001 |
| North Africa countries | 20/237 (8.5) | 18/68 (26.5) | 3/61 (5.0) | 3/63 (4.7) | 6/52 (10.7) | 9/93 (9.5) | |
| Other African countries | 26/237 (11.1) | 1/68 (1.1) | 4/61 (6.3) | 6/63 (9.9) | 9/52 (16.9) | 11/93 (11.4) | |
| Other | 17/237 (7.3) | 3/68 (4.5) | 3/61 (5.0) | 6/63 (9.9) | 5/52 (9.0) | 4/93 (4.6) | |
| Maternal level of education | |||||||
| <Higher secondary school | 64/222 (28.8) | 30/66 (45.7) | 15/60 (24.7) | 14/58 (24.3) | 9/46 (18.6) | 19/72 (27.9) | .06 |
| Higher secondary school | 39/222 (17.6) | 12/66 (17.6) | 15/60 (25.5) | 13/58 (21.5) | 13/46 (27.5) | 16/72 (21.5) | |
| High school diploma +1 +2 | 53/222 (23.7) | 9/66 (14.1) | 9/60 (14.9) | 20/58 (35.1) | 10/46 (23.1) | 19/72 (26.3) | |
| >High school diploma +3 | 66/222 (29.9) | 15/66 (22.7) | 21/60 (34.9) | 11/58 (19.2) | 14/46 (30.8) | 18/72 (24.3) | |
| Maternal BMI before pregnancy | |||||||
| Underweight | 16/222 (7.2) | 4/64 (6.5) | 4/59 (6.5) | 3/60 (5.0) | 4/47 (8.7) | 7/83 (9.0) | .49 |
| Underweight or normal | 138/222 (62.0) | 36/64 (56.0) | 36/59 (61.3) | 38/60 (63.8) | 28/47 (59.0) | 46/83 (55.0) | |
| Overweight | 40/222 (17.8) | 8/64 (12.5) | 13/59 (22.2) | 14/60 (22.6) | 11/47 (24.3) | 19/83 (22.8) | |
| Obese | 28/222 (13.0) | 16/64 (25.0) | 6/59 (10.0) | 5/60 (8.6) | 4/47 (8.1) | 11/83 (13.1) | |
| Neonatal factors | |||||||
| Male | 121/240 (50.3) | 32/68 (46.2) | 35/61 (57.6) | 37/63 (60.0) | 33/52 (64.4) | 42/93 (45.2) | .15 |
| Birth weight Z-score, mean (SD)b | 240 0.1 (1.0) | 68 0.4 (1.1) | 61 0.1 (1.0) | 63 0.4 (0.9) | 52 0.4 (1.1) | 93 0.3 (1.1) | .03 |
| Cesarean delivery | 166/240 (70.0) | 40/68 (58.7) | 32/61 (53.4) | 38/63 (63.0) | 38/51 (76.4) | 56/93 (62.9) | .05 |
| Surfactant during first days of life | 155/238 (64.0) | 42/66 (62.9) | 32/61 (51.2) | 49/62 (78.1) | 43/49 (86.8) | 77/93 (80.9) | <.001 |
| Attempted CPAP in the first 24 h of life | 171/236 (73.2) | 55/66 (84.8) | 46/61 (76.5) | 36/60 (62.8) | 21/49 (43.7) | 47/91 (54.0) | <.001 |
| Ductus arterious treatment before day 10 | 41/237 (16.8) | 13/67 (18.0) | 7/58 (11.5) | 29/62 (44.7) | 18/51 (33.5) | 41/91 (42.4) | <.001 |
| Early neonatal infection | 48/234 (20.0) | 14/67 (20.4) | 21/59 (35.5) | 15/61 (24.1) | 18/50 (36.5) | 22/90 (23.9 | .05 |
| Late infection (after 72 h of life and before the stool collect) | 85/229 (35.7) | 10/65 (14.7) | 14/60 (21.7) | 35/60 (56.5) | 41/52 (78.5) | 75/90 (82.1) | <.001 |
| Low volume of enteral nutrition at day 7 | 60/240 (24.4) | 19/68 (26.9) | 18/61 (29.4) | 29/63 (44.3) | 34/52 (65.0) | 59/93 (62.4) | <.001 |
| Gastrointestinal transit considered normal (at least 1 stool a day) | 152/227 (67.5) | 39/66 (59.9) | 44/57 (77.9) | 28/60 (46.8) | 13/50 (25.9) | 40/86 (46.8) | <.001 |
| Practice of skin-to-skin contact during the first week of life | 147/232 (64.2) | 40/64 (63.2) | 43/59 (73.9) | 31/57 (55.2) | 16/45 (34.8) | 29/77 (39.2) | <.001 |
| Breast milk during first week | 139/239 (57.6) | 43/68 (62.9) | 46/61 (75.6) | 40/60 (67.0) | 33/52 (63.9) | 59/93 (62.7) | .17 |
| NICU's strategyc | |||||||
| No intubation or extubation at day 1 | 95/240 (38.8) | 28/68 (41.3) | 27/61 (44.1) | 23/63 (36.6) | 15/52 (28.8) | 28/93 (30.5) | .40 |
| Sedation during the first week | 161/240 (67.7) | 46/68 (66.6) | 44/61 (72.3) | 46/63 (73.7) | 43/52 (82.5) | 65/93 (70.5) | .40 |
| Medication to close ductus arteriosus before day 10 | 128/240 (54.3) | 40/68 (58.3) | 34/61 (56.3) | 40/63 (63.8) | 32/52 (62.2) | 47/93 (50.5) | .58 |
| Longer duration of primary antibiotherapy | 89/240 (37.9) | 18/68 (25.7) | 27/61 (45.4) | 21/63 (32.7) | 16/52 (28.7) | 26/93 (26.7) | .07 |
| Longer duration of secondary antibiotherapy | 113/240 (46.8) | 23/68 (34.5) | 21/61 (34.9) | 21/63 (31.9) | 15/52 (27.1) | 43/93 (45.2) | .03 |
| Low volume of enteral nutrition at day 7 | 60/240 (25.0) | 29/68 (44.0) | 11/61) (18.1 | 27/63 (43.1) | 18/52 (35.0) | 35/93 (36.3) | .001 |
| Skin to skin during the first week | 145/240 (60.3) | 41/68 (60.6) | 48/61 (79.4) | 37/63 (59.5) | 23/52 (42.9) | 47/93 (49.8) | <.001 |
| Direct breastfeeding during the first week | 32/240 (12.4) | 4/68 (5.7) | 16/61 (25.6) | 3/63 (4.3) | 2/52 (3.4) | 6/93 (6.8) | .002 |
Abbreviations: BMI, body mass index, calculated as weight in kilograms divided by height in meters squared; CPAP, continuous positive airway pressure; NICU, neonatal intensive care unit.
a
Percentages are weighted to account for differences in sampling process between gestational ages. Denominators vary according to the number of missing data for each variable.
b
Score based on Olsen curves.
c
Favorable strategy: the observed percentage was zero or greater than the expected percentage of newborn receiving the treatment or practice.