Transient Gut Microbiota Modulation and Bacteroides Predict Constipation Recurrence in Cerebral Palsy: A 4-Year Synbiotics Study

Transient Gut Microbiota Modulation and Bacteroides Predict Constipation Recurrence in Cerebral Palsy: A 4-Year Synbiotics Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Transient Gut Microbiota Modulation and Bacteroides Predict Constipation Recurrence in Cerebral Palsy: A 4-Year Synbiotics Study Xiaoli Li, Weikeng Yang, Chunyan Wang, Peiqin Wang, Meng Dongming, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7150409/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background: Children with cerebral palsy (CP) suffer high constipation rates (26-74%) linked to gut microbiota (GM) dysbiosis. While synbiotics show short-term efficacy, long-term GM stability post-intervention is unknown. Methods: In a 4-year longitudinal study, 25 CP children with chronic constipation received 6-month synbiotics. Fecal 16S rRNA sequencing was performed at baseline (Pre), 6 months (M6), and 48 months post-intervention (M48). Recurrence status defined subgroups (nonrecurrent CNC=21, recurrent CC=4). Results: Shannon diversity increased at M6 vs. Pre (Δ=1.2, P=0.019) but regressed to baseline at M48 (P=0.008). Baseline Bacteroides >0.1% predicted reduced recurrence risk (OR=3.2, 95%CI:1.5–6.8, P=0.009). Metagenomic prediction revealed persistent BCAA biosynthesis enrichment in CC vs. CNC at M48 (q<0.05), while CNC showed upregulated tryptophan metabolism. Conclusions: Synbiotic-induced GM benefits are transient in CP children. Baseline Bacteroides abundance and distinct microbial metabolic signatures may stratify recurrence risk, informing personalized long-term constipation management. Cerebral palsy Pediatric constipation Brain-gut axis Synbiotics Bacteroides Longitudinal study Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryTableS1BeforeIntervention.xlsx SupplementaryTableS2at6monthsofintervention.xlsx SupplementaryTableS3at4yearsofintervention.xlsx SupplementaryTableS4at6monthsofintervention.xlsx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 16 Sep, 2025 Editor invited by journal 20 Aug, 2025 Editor assigned by journal 30 Jul, 2025 Submission checks completed at journal 29 Jul, 2025 First submitted to journal 29 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7150409","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":519523227,"identity":"8c3662ba-724f-406f-8f41-26dbebf18988","order_by":0,"name":"Xiaoli Li","email":"","orcid":"","institution":"Longgang Maternity and Child Institute of Shantou University Medical College)","correspondingAuthor":false,"prefix":"","firstName":"Xiaoli","middleName":"","lastName":"Li","suffix":""},{"id":519523228,"identity":"d1b5d829-b246-471b-8e9d-17b4f221f341","order_by":1,"name":"Weikeng Yang","email":"","orcid":"","institution":"Longgang District 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cerebral palsy, Pediatric constipation, Brain-gut axis, Synbiotics, Bacteroides, Longitudinal study","lastPublishedDoi":"10.21203/rs.3.rs-7150409/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7150409/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Children with cerebral palsy (CP) suffer high constipation rates (26-74%) linked to gut microbiota (GM) dysbiosis. While synbiotics show short-term efficacy, long-term GM stability post-intervention is unknown.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: In a 4-year longitudinal study, 25 CP children with chronic constipation received 6-month synbiotics. Fecal 16S rRNA sequencing was performed at baseline (Pre), 6 months (M6), and 48 months post-intervention (M48). Recurrence status defined subgroups (nonrecurrent CNC=21, recurrent CC=4).\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: Shannon diversity increased at M6 vs. Pre (Δ=1.2, P=0.019) but regressed to baseline at M48 (P=0.008). Baseline Bacteroides \u0026gt;0.1% predicted reduced recurrence risk (OR=3.2, 95%CI:1.5–6.8, P=0.009). Metagenomic prediction revealed persistent BCAA biosynthesis enrichment in CC vs. CNC at M48 (q\u0026lt;0.05), while CNC showed upregulated tryptophan metabolism.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: Synbiotic-induced GM benefits are transient in CP children. Baseline Bacteroides abundance and distinct microbial metabolic signatures may stratify recurrence risk, informing personalized long-term constipation management.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Transient Gut Microbiota Modulation and Bacteroides Predict Constipation Recurrence in Cerebral Palsy: A 4-Year Synbiotics Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-24 21:48:46","doi":"10.21203/rs.3.rs-7150409/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-09-16T07:08:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-20T19:13:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-30T17:55:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-30T02:11:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-07-30T02:09:51+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ab7311f3-b851-474f-abf2-2fdbd3a00e72","owner":[],"postedDate":"September 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-24T21:48:46+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-24 21:48:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7150409","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7150409","identity":"rs-7150409","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}