Maternal balanced energy-protein supplementation reshapes the maternal gut microbiome and enhances carbohydrate metabolism in infants: a randomized controlled trialOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study examined whether balanced energy-protein (BEP) supplementation given to mothers during pregnancy and the first six months of lactation changes the maternal and infant gut microbiome. It was nested within the MISAME-III randomized controlled trial, which originally tested BEP supplementation's effect on small-for-gestational-age prevalence and infant length-for-age Z-scores. The sub-study used metagenomic sequencing of maternal and infant stool to assess microbiome diversity, composition, and function. It also explored whether microbiome changes mediate the trial's effects on birth outcomes and infant growth.
Who was studied?
The sub-study included 152 mother-infant dyads from the MISAME-III trial conducted in rural Burkina Faso, with 71 dyads in the BEP intervention group and 81 in the control group. Stool samples were collected from mothers at the second and third trimesters of pregnancy, and from infants at 1 to 2 months and 5 to 6 months postpartum. This design allowed comparison of microbiome trajectories across pregnancy and early infancy between supplemented and non-supplemented mother-infant pairs.
What were the most important findings?
BEP supplementation significantly altered the diversity, composition, and functional pathways of the maternal gut microbiome, particularly pathways with immune-modulatory properties. Lipopolysaccharide biosynthesis pathways were depleted in the gut microbiomes of BEP-supplemented mothers, while the species Bacteroides fragilis was enriched. Maternal BEP supplementation also accelerated changes in the infant gut microbiome and enhanced infant carbohydrate metabolism.
What are the greatest implications of this study?
The findings suggest that maternal nutritional supplementation during pregnancy and lactation can shape the maternal gut microbiome in ways that may reduce inflammatory potential, evidenced by depleted lipopolysaccharide biosynthesis pathways and enriched Bacteroides fragilis. Because BEP supplementation also influenced infant microbiome development and carbohydrate metabolism, the maternal gut microbiome may serve as a mediating pathway linking prenatal nutrition to infant growth outcomes. This supports the gut microbiome as a plausible mechanistic target for nutritional interventions aimed at improving birth and early-life outcomes in undernourished populations.