Abstract

We studied whether probiotics were beneficial for hormonal change-associated dysbiosis, which may influence the enteric nervous system and GI function during early pregnancy. The study was 16 days consisting of two cycles of six daily probiotics mainly Lactobacillus and 2 days without probiotics. Daily surveys were conducted to monitor GI function and life quality. A subset of the participants who contributed fecal specimens was used for microbiota metagenomic sequencing, metabolomics, and quantification of bacterial genes to understand potential underlying mechanisms. Statistical analyses were done by generalized linear mixed-effects models. Thirty-two obstetric patients and 535 daily observations were included. The data revealed that probiotic supplementation significantly reduced the severity of nausea, vomiting, constipation, and improved life quality. Moreover, a low copy number of fecal bsh (bile salt hydrolase), which generates free bile acids, was associated with high vomiting scores and probiotic intake increased fecal bsh. In exploratory analysis without adjusting for multiplicity, a low fecal α-tocopherol, as well as a high abundance of Akkemansia muciniphila, was associated with high vomiting scores and times, respectively. The potential implications of these biomarkers in pregnancy and GI function are discussed. Probiotics likely produce free bile acids to facilitate intestinal mobility and metabolism.

Highlights

  • Nausea and vomiting affect about 85% of pregnant women and have a significantly negative impact on life quality during early pregnancy

  • Probiotic intake increased the abundance of BSH-generating bacteria, which produced free bile acids thereby enhancing GI motility and metabolism leading to improved GI function

  • This novel study has revealed the beneficial effects of probiotics in reducing GI dysfunction during pregnancy

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Summary

Introduction

Nausea and vomiting affect about 85% of pregnant women and have a significantly negative impact on life quality during early pregnancy. Gut microbiota via generated metabolites affect host health. We tested a hypothesis that probiotics may shift gut microbiota and metabolites to affect GI function during early pregnancy. Based on 32 enrolled participants and observations over hundreds of days, data showed that probiotics significantly improved daily nausea and vomiting scores as well as overall life quality. Fecal biomarkers including vitamin E, A. muciniphila, and the copy number of bile salt hydrogenase gene (bsh, BSH) may predict the severity of vomiting. Probiotic intake increased the abundance of BSH-generating bacteria, which produced free bile acids thereby enhancing GI motility and metabolism leading to improved GI function

Study Design
Data and Specimen Collection
Quantification of Bacteria Genes
Shotgun Metagenomic Sequencing
Bioinformatic Analysis
Untargeted Metabolomic Analysis
Statistical Analysis
The Effect of Probiotics on Symptoms
The Effect of Probiotics on Fecal Metabolites
The Effect of Probiotics on Fecal Microbiota
The Relationships between Biomarkers and Symptoms
Discussion
A Systematic forfor
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