Microbiome alterations in women with gestational diabetes mellitus and their offspring: A systematic review

Abstract

AimsGestational diabetes mellitus (GDM) is a metabolic disorder that might predispose pregnant women to develop type 2 Diabetes Mellitus or lead to severe adverse outcomes in their offspring. One of the factors that have been thought to be involved in the pathology behind this disorder is the microbiome. In this systematic review, we comprehensively review the documents regarding the microbiota alterations in different tracts of pregnant women with GDM and their offspring.MethodsA comprehensive search was conducted in major databases including MEDLINE (PubMed), Scopus, and Web of sciences up to August 2021. Data on the demographics, methodology, and microbiome alterations were extracted and classified according to the type of microbiome in pregnant women with GDM and their offspring. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS).ResultsIn 49 articles which were retrieved, the findings were variable on the level of changes in alpha and beta diversity, enrichment or depletion in phyla, genera, species and OTUs, in each microbiome type. Although there were some inconsistencies among the results, a pattern of significant alterations was seen in the gut, oral, vaginal microbiome of women with GDM and gut, oral, and placental microbiome of their offspring.ConclusionEven though the alteration of the microbiome of the different tracts was seen in the cases of GDM, the inconsistency among the studies prevents us from identifying unique pattern. However, the results seem promising and further studies that overcome the confounding factors related to the demographics and methodology are needed.

Oral probiotics increased the proportion of Treg, Tfr, and Breg cells to inhibit the inflammatory response and impede gestational diabetes mellitus

“…Similarly, research has shown that postpartum gut dysbiosis still exists and may affect the development of newborns (Farhat et al 2022 ). In the evolution process of GDM, probiotic supplements are appropriate for blood sugar control and provide the most powerful evidence for fetal development and postpartum (Mu et al 2023 ).…”

The Association between Gestational Diabetes and the Microbiome: A Systematic Review and Meta-Analysis

“…Bifidobacterium is known as a beneficial acetate- and lactate-producing bacteria. The diminished relative abundance of this genus in the GDM group can be interpreted considering the role of Bifidobacteria in the fermentative metabolism, carbohydrate degradation, and intracellular uptake of short oligosaccharides [ 22 , 52 , 53 ]. These findings are consistent with the recommendation of probiotic supplementation based on this genus [ 54 ].…”

“…This systematic review with meta-analysis aims to update the previous reviews on this topic [ 21 , 22 ], including the new data available, summarizing and quantifying all relevant information to describe the current state of knowledge regarding the relationship between the microbiome and GDM. This review provides a comprehensive summary of the evidence on this topic, identifies areas of agreement and disagreement in the literature, and suggests directions for future research.…”

Fusobacterium nucleatum: An Overview of Evidence, Demi-Decadal Trends, and Its Role in Adverse Pregnancy Outcomes and Various Gynecological Diseases, including Cancers

“…nucleatum, detected in the neonatal microbiome, was found to be absent in the mother's urogenital tract but present in their oral cavity. This suggests that the bacteria may have been transferred through the bloodstream due to its ability to adhere to vascular epithelium [87]. A review article from China [16] also highlighted that injecting saliva or subgingival plaque samples into mice can lead to placental infection with oral commensal species, including F. nucleatum, suggestingthat oral bacteria have the ability to travel to the feto-placental unit.…”