Maternal fecal microbiome predicts gestational age, birth weight and neonatal growth in rural Zimbabwe.

Abstract

Background: Preterm birth and low birth weight (LBW) affect one in ten and one in seven livebirths, respectively, primarily in low-income and middle-income countries (LMIC) and are major predictors of poor child health outcomes. However, both have been recalcitrant to public health intervention. The maternal intestinal microbiome may undergo substantial changes during pregnancy and may influence fetal and neonatal health in LMIC populations. Methods: Within a subgroup of 207 mothers and infants enrolled in the SHINE trial in rural Zimbabwe, we performed shotgun metagenomics on 351 fecal specimens provided during pregnancy and at 1-month postpartum to investigate the relationship between the pregnancy gut microbiome and infant gestational age, birth weight, 1-month length-, and weight-for-age z-scores using extreme gradient boosting machines. Findings: Pregnancy gut microbiome taxa and metabolic functions predicted birth weight and WAZ at 1 month more accurately than gestational age and LAZ. Blastoscystis sp, Brachyspira sp and Treponeme carriage were high compared to Western populations. Resistant starch-degraders were important predictors of birth outcomes. Microbiome capacity for environmental sensing, vitamin B metabolism, and signalling predicted increased infant birth weight and neonatal growth; while functions involved in biofilm formation in response to nutrient starvation predicted reduced birth weight and growth. Interpretation: The pregnancy gut microbiome in rural Zimbabwe is characterized by resistant starchdegraders and may be an important metabolic target to improve birth weight. Funding: Bill and Melinda Gates Foundation,

The Potential of Metabolomic Analyses as Predictive Biomarkers of Preterm Delivery: A Systematic Review

“…Although of great interest for future research, we did not include maternal fecal metabolites or the fecal microbiome in the clinical workup of preterm birth in the original search as this was beyond the scope of our review. However, Gough et al ( 44 ) recently demonstrated that the presence of Slackia isoflavonivonvertens in fecal samples of 207 pregnant women (22.8% of women in their first trimester, 60.9% in their second trimester and 16.3% in their third trimester) could contribute to a longer gestational age. Importantly, the presence of Prevotella copri , a microbe associated with host inflammation, was prospectively detected more frequently in women who delivered preterm.…”

Increasing pregnancy duration, fetal and early postnatal growth in LMIC: The importance of a gut microbiome that exploits dietary staples

“…The overall study results indicated that the nutritional but not the sanitation intervention improved infant growth [9]. In the current analysis of a subset of the Zimbabwean participants, there were clear relationships between microbial functional capacity and birthweight and early postnatal growth and these were seen to a lesser extent with gestational age as well [8]. The ability of the maternal microbiome to degrade resistant starch, which is mainly consumed in the form of maize as a mainstay of the diet in Zimbabwe, was associated with significant increases in birthweight (by 200g) and weight for age z-scores at one month of age (by up to 0.75 standard deviations).…”

“…In this issue of EBioMedicine, Gough et al [8] investigated the impact of the maternal microbiome composition on gestational age at birth, birthweight, and infant growth in the first month of life in a Zimbabwean sub-cohort of the larger SHINE (Sanitation, Hygiene, Infant Nutrition efficacy) study. SHINE aimed to improve infant growth by reducing environmental enteric dysfunction through a nutrition intervention from six months of age and through a sanitation intervention, which provided latrines, water treatment and general hygiene education in a 2 £ 2 factorial design.…”

Taxonomic and functional shifts in the perinatal gut microbiome of rhesus macaques

“…It is well established that the gut microbiome can modulate these shifts. Indeed, a recent study of a cohort in rural Zimbabwe found that the taxonomic composition of the maternal fecal microbiome was a strong predictor of gestational age, birth weight, and neonatal growth (46). However, our understanding of the changes that the maternal gut microbiome undergoes during the perinatal period is limited.…”