Changes in the gut microbiota composition during pregnancy in patients with gestational diabetes mellitus (GDM)

Abstract

Gestational diabetes mellitus (GDM), a common pregnancy complication, is associated with an increased risk of maternal/perinatal outcomes. We performed a prospective observational explorative study in 41 GDM patients to evaluate their microbiota changes during pregnancy and the associations between the gut microbiota and variations in nutrient intakes, anthropometric and laboratory variables. GDM patients routinely received nutritional recommendations according to guidelines. The fecal microbiota (by 16S amplicon-based sequencing), was assessed at enrolment (24–28 weeks) and at 38 weeks of gestational age. At the study end, the microbiota α-diversity significantly increased (P < 0.001), with increase of Firmicutes and reduction of Bacteroidetes and Actinobacteria. Patients who were adherent to the dietary recommendations showed a better metabolic and inflammatory pattern at the study-end and a significant decrease in Bacteroides. In multiple regression models, Faecalibacterium was significantly associated with fasting glucose; Collinsella (directly) and Blautia (inversely) with insulin, and with Homeostasis-Model Assessment Insulin-Resistance, while Sutterella with C-reactive protein levels. Consistent with this latter association, the predicted metagenomes showed a correlation between those taxa and inferred KEGG genes associated with lipopolysaccharide biosynthesis. A higher bacterial richness and strong correlations between pro-inflammatory taxa and metabolic/inflammatory variables were detected in GDM patients across pregnancy. Collectively these findings suggest that the development of strategies to modulate the gut microbiota might be a potentially useful tool to impact on maternal metabolic health.

Exercise improves metabolic function and alters the microbiome in rats with gestational diabetes

“…Leptin plays a major role in the chronic pro-inflammatory pathway leading to diabetes. 18 These data support the hypothesis that there is an interplay between glucose intolerance and inflammation, suggesting a role for gut microbes in GDM. 34,35 Thus, increased plasma leptin concentrations in the present study may contribute to the development and exacerbation of GDM in HFD females.…”

“…Our recent review highlights that the adolescent period is critical for establishing optimal health. 18 Studies in mice have also revealed that shifts in the maternal gut microbiome, in association with altered metabolism are dependent on the mothers' diet prior to and during pregnancy. 11,12 Indeed, healthy weight pregnant women who exercised 1 year before pregnancy have a greater reduction in GDM risk 13,14 than women who exercised only during pregnancy.…”

The fecal metabolome is associated with gestational diabetes mellitus

“…5 Gut microbiota has been recently correlated with GDM. 6,7 GDM is featured with dysbiosis in gut microbiota. The ratio of control-enriched bacteria to GDM enriched bacteria is negatively correlated with hyperglycemia.…”

Association between gut microbiota composition and glycoalbumin level during pregnancy in Japanese women: Pilot study from Chiba Study of Mother and Child Health

“…Several studies have investigated gut microbiota during pregnancy. Most of those studies reported that gut microbiota is altered during pregnancy. Koren et al.…”