Abstract
Hormonal changes during and after pregnancy are linked with modifications in the maternal microbiota. We describe the importance of the maternal microbiota in pregnancy and examine whether changes in maternal microbiotic composition at different body sites (gut, vagina, endometrium) are associated with pregnancy complications. We analyze the likely interactions between microbiota and the immune system. During pregnancy, the gastrointestinal (gut) microbiota undergoes profound changes that lead to an increase in lactic acid–producing bacteria and a reduction in butyrate-producing bacteria. The meaning of such changes needs clarification. Additionally, several studies have indicated a possible involvement of the maternal gut microbiota in autoimmune and lifelong diseases. The human vagina has its own microbiota, and changes in vaginal microbiota are related to several pregnancy-related complications. Recent studies show reduced lactobacilli, increased bacterial diversity, and low vaginal levels of beta-defensin 2 in women with preterm births. In contrast, early and healthy pregnancies are characterized by low diversity and low numbers of bacterial communities dominated by Lactobacillus. These observations suggest that early vaginal cultures that show an absence of Lactobacillus and polymicrobial vaginal colonization are risk factors for preterm birth. The endometrium is not a sterile site. Resident endometrial microbiota has only been defined recently. However, questions remain regarding the main components of the endometrial microbiota and their impact on the reproductive tract concerning both fertility and pregnancy outcomes. A classification based on endometrial bacterial patterns could help develop a microbiota-based diagnosis as well as personalized therapies for the prevention of obstetric complications and personalized treatments through nutritional, microbiotic, or pharmaceutical interventions.
Highlights
The human body is host to a community of microorganisms, including viruses, bacteria, and fungi
They identified that the bacteria associated with PE were associated with other host morbidities, including obesity, higher incidence of glucose metabolic disorders, proinflammatory states, and intestinal barrier dysfunction. These microorganisms correlated with host immune parameters, such as interleukin-6 and lipopolysaccharide (LPS), the major component of the outer membrane of Gram-negative bacteria. These findings suggest that an altered gut microbiota during early pregnancy may be involved in the development of pregnancy-related complications, such as early-onset PE
We find that increased intestinal permeability in early pregnancy is associated with increased maternal levels of LPS, excessive inflammasomemediated production of cytokines at the endometrial level, and last, increased risk of pregnancy loss [37, 38]
Summary
The human body is host to a community of microorganisms, including viruses, bacteria, and fungi. A major contribution to this debate illustrates how the transient colonization of pregnant female mice with engineered Escherichia coli may modify the levels of intestinal innate immune composition in mother and offspring This suggests that gut maternal microorganisms may play a role in the regulation of the immune system of newborns [9]. Several factors have been known to influence the human microbiota, such as ancestry, antibiotic use, lifestyle, dietary habits, exercise frequency, and body mass index (BMI) [10]. This means that there is no unique health or disease indicator related to the microbiota, yet each individual has a different microbiota from that of others. Demonstration that an altered microbiota may be linked to maternal and fetal complications is an important target in personalized medicine
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