Research Article: Michigan cohorts to determine associations of maternal pre-pregnancy body mass index with pregnancy and infant gastrointestinal microbial communities: Late pregnancy and early infancy

Date Published: March 18, 2019

Publisher: Public Library of Science

Author(s): Kameron Y. Sugino, Nigel Paneth, Sarah S. Comstock, Cheryl S. Rosenfeld.


About 25% of women in the United States are obese prior to becoming pregnant. Although there is some knowledge about the relationship between the gastrointestinal microbiota and obesity, little is known about the relationship between pre-pregnancy obesity and the gastrointestinal microbiota in pregnancy or its impact on infant gut microbiota. However, the composition of the gut microbiota early in life may influence childhood health. Thus, the objective of this research was to identify associations between maternal pre-pregnancy obesity and the pregnancy (n = 39) or early infancy (n = 39) microbiotas.

Fecal bacterial communities from overweight women had lower microbiota diversity (Chao1: p = 0.02; inverse Simpson: p = 0.05; Shannon: p = 0.02) than communities from normal weight or obese women. The within-group microbiota composition of overweight women differed from those of normal and obese women at the genus and phylum levels (p = 0.003 and p = 0.02, respectively). Pre-pregnancy overweight women had higher abundances of Bacteroides and lower Phascolarctobacterium than women who were normal weight or obese prior to becoming pregnant. Normal weight women had lower abundances of Acidaminococcus and Dialister than overweight and obese women. Infant community composition tended to differ in membership (Sorensen index) by maternal pre-pregnancy BMI category, and significantly differed by delivery mode and breastfeeding exclusivity (p = 0.06, p = 0.001, p = 0.008, respectively). Infants from normal weight women had lower abundances of Megasphaera than infants from overweight or obese women. Streptococcus was lowest in infants from overweight women, and Staphylococcus was lowest in infants from obese women.

Maternal and infant microbiotas are associated with and might be affected by maternal pre-pregnancy BMI. Future work should determine if there are also functional differences in the infant microbiome, if those functional differences are related to maternal pre-pregnancy BMI, and whether differences in composition or traits persist over time.

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The gut hosts a diverse community of microbes that interact with biological functions in both humans and animals. For example, the gut microbiota impacts immune system development, digestion of food components and influences weight gain [1–4]. In mice, the presence of a gut microbiota promotes increased adiposity and weight gain, possibly by increasing the amount of energy extracted and absorbed from food [1, 3, 5, 6]. Similarly, germ-free mice transplanted with the microbiota from an obese human twin have more body fat compared to mice that receive a microbiota transplant from the lean twin [1]. In healthy human adults, there is evidence that shifts in the Firmicutes and Bacteroidetes abundances are associated with weight gain and obesity, though these shifts in phyla abundances are not consistent between studies [1, 7, 8]. Thus, although there is strong evidence for a relationship between gut microbiota and obesity in mice, the evidence in humans is weak [8]. To address this question more definitively in humans, analysis of these communities during pregnancy and early infancy [9, 10] can inform how the gut microbiota is associated with maternal pre-pregnancy BMI. While it is known that maternal pre-pregnancy BMI is associated with infant development and child weight [11, 12], it’s unknown why these relationships exist. However, these effects may be mediated through the pregnancy and infancy microbiotas [13].

In this population of pregnant women and infants, we investigated the relationship between maternal pre-pregnancy BMI and the gut microbiota of women during late pregnancy and of their children during early infancy. The fecal bacterial communities of women who were overweight prior to becoming pregnant differed from those of women who were normal weight and obese prior to becoming pregnant. The overweight women had a lower alpha diversity and a high abundance of Bacteroides, which was likely the main driver of their overall community differences measured by beta diversity, compared to the other BMI categories. The alpha diversity of the infant microbiota did not differ by any of variables tested, but the beta diversity of the infant microbiota was associated with delivery mode, human milk in the diet and antibiotic exposure when analyzed independently. However, only exclusive breastfeeding was significantly associated with the infant gut microbiota after stratifying by maternal pre-pregnancy BMI category.

Maternal pre-pregnancy BMI is associated with the pregnancy fecal bacterial community and tends to be associated with the early infancy fecal bacterial community. Other maternal characteristics and environmental exposures were also associated with the microbiota during early infancy. Factors such as pre-pregnancy BMI, C-section delivery and formula feeding, affect the infant microbiota and have also been shown to increase the risk of developing adverse health outcomes such as childhood overweight/obesity [68] and allergies/asthma [69–71]. The health effects associated with these factors may partially be explained by their effects on the microbiota. Other characteristics of the infant microbiome, such as species, strain, or functional differences, are important aspects of microbiota-host interactions and may give further insight on the roles the microbiota plays in childhood development. Future work will determine if these bacterial differences persist as the child ages as well as describe associations between the microbiota and later health outcomes.




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