Maternal Microbiome and Pregnancy Outcomes That Impact Infant Health

Dunlop, Anne L.; Mullé, Jennifer G.; Ferranti, Erin P.; Edwards, Sara; Dunn, Alexis; Corwin, Elizabeth J.

doi:10.1097/anc.0000000000000218

Cited by 160 publications

(130 citation statements)

References 163 publications

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“…The typical Western diet consists of excessive processed foods, dietary fat and sugars (Morrison & Regnault, 2016). Such a diet promotes excess weight gain and a dysbiotic gut and is associated with adverse maternal and child health outcomes (Dunlop et al, 2015; Morrison & Regnault, 2016). Conversely, certain dietary nutrients, namely low-fat protein (for instance beans, skinless chicken, lean beef), organic proteins and produce (which reduces exposure to dietary antibiotics and pesticides), unsaturated fatty acids (for instance in canola and olive oils, flaxseeds, and salmon), whole grains, and certain strains of probiotics have been found to promote a healthy gut microbiome, enhance intestinal integrity and reduce excessive systemic inflammation (Griffin, 2015; Kashtanova et al, 2016).…”

Section: Factors That Can Modify the Gut Microbiomementioning

confidence: 99%

The Maternal Gut Microbiome During Pregnancy

Edwards

Cunningham

Dunlop

et al. 2017

McN: The American Journal of Maternal/Child Nursing

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155

115

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The gut microbiome is a critical component of an individual’s metabolism and overall health. The prenatal period is marked by unique inflammatory and immune changes that alter maternal gut function and bacterial composition as the pregnancy advances. The composition of the maternal gut microbiome contributes to obstetric outcomes with long-term health sequelae for mother and child. Estrogen and progesterone also impact gut function, especially during the prenatal period. These physiologic changes in pregnancy allow for adjustments in maternal metabolism and weight necessary to support the pregnancy. This article will review the normal hormonal, metabolic and immunologic changes to the maternal gut microbiome throughout the prenatal period, in addition to relevant implications for nurses providing care for pregnant women.

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Section: Factors That Can Modify the Gut Microbiomementioning

confidence: 99%

The Maternal Gut Microbiome During Pregnancy

Edwards

Cunningham

Dunlop

et al. 2017

McN: The American Journal of Maternal/Child Nursing

Self Cite

155

115

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“…If an aberrant or dysbiotic gut microbiome is the source of the microbes that underpin PE, it is at least plausible that the gut microbiome should be predictive of PE (378), but we know of no suitably powered study that has been done to assess this, and this would clearly be worthwhile. However, in a study of primiparous women, the OR for getting severe PE was only 0.6 if probiotic milk drinks containing lactobacilli were consumed daily (1252).…”

Section: Prevention Strategiesmentioning

confidence: 99%

A Dormant Microbial Component in the Development of Preeclampsia

Kell

Kenny

2016

Front. Med.

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Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of “preeclampsia” that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.

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“…Lactobacilli produce an acidic vaginal environment, a protective factor for development of potentially harmful organisms in the vagina. A vaginal microbiome with a higher pH and greater diversity of anaerobic species also contributes to a higher incidence of sexually transmitted infections and growth of other organisms associated with adverse pregnancy outcomes including preterm birth (Huang, 2014; Dunlop et al, 2015). …”

Section: Implications Of Route Of Birthmentioning

confidence: 99%

The Maternal Infant Microbiome

Dunn

Jordan

Baker

et al. 2017

McN: The American Journal of Maternal/Child Nursing

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The human microbiome plays a role in maintaining health, but is also thought to attenuate and/or exacerbate risk factors for adverse maternal-child health outcomes. The development of the microbiome begins in utero, however factors related to the labor and birth environment have been shown to influence the initial colonization process of the newborn microbiome. This “seeding” or transfer of microbes from the mother to newborn may serve as an early inoculation process with implications for the long-term health outcomes of newborns. Studies have shown that there are distinct differences in the microbiome profiles of newborns born vaginally compared to those born by cesarean. Antibiotic exposure has been shown to alter the microbial profiles of women and may influence the gut microbial profiles of their newborns. Considering that the first major microbial colonization occurs at birth, it is essential that labor and birth nurses be aware of factors that may alter the composition of the microbiome during the labor and birth process. The implications of various activities and factors unique to the labor and birth environment that may influence the microbiome of women and newborns during the labor and birth process (e.g. route of birth, antibiotic use, nursing procedures) are presented with a focus on the role of labor nurses and the potential influence of nursing activities on this process.

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Maternal Microbiome and Pregnancy Outcomes That Impact Infant Health

Cited by 160 publications

References 163 publications

The Maternal Gut Microbiome During Pregnancy

The Maternal Gut Microbiome During Pregnancy

A Dormant Microbial Component in the Development of Preeclampsia

The Maternal Infant Microbiome

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