The maternal gut microbiome in pregnancy: implications for the developing immune system

• Published in: Nature reviews. Gastroenterology & hepatology 2024-01, Vol.21 (1), p.35-45
• Main Authors: Koren, Omry, Konnikova, Liza, Brodin, Petter, Mysorekar, Indira U., Collado, Maria Carmen
• Format: Article
• Language: English
• Subjects: 631/250; 631/326; Antigens; Biomedicine; Breast feeding; Breastfeeding & lactation; Digestive system; Dysbacteriosis; Fetuses; Gastroenterology; Hepatology; Homeostasis; Immune system; Immunity; Immunology; Intestinal microflora; Lymphocytes; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Metabolism; Metabolites; Microbiomes; Microbiota; Microorganisms; Neonates; Pathogens; Physiology; Pregnancy; Pregnancy complications; Review Article; Vagina
• ISSN: 1759-5045; 1759-5053; 1759-5053
• DOI: 10.1038/s41575-023-00864-2

The gut microbiome has important roles in host metabolism and immunity, and microbial dysbiosis affects human physiology and health. Maternal immunity and microbial metabolites during pregnancy, microbial transfer during birth, and transfer of immune factors, microorganisms and metabolites via breastfeeding provide critical sources of early-life microbial and immune training, with important consequences for human health. Only a few studies have directly examined the interactions between the gut microbiome and the immune system during pregnancy, and the subsequent effect on offspring development. In this Review, we aim to describe how the maternal microbiome shapes overall pregnancy-associated maternal, fetal and early neonatal immune systems, focusing on the existing evidence and highlighting current gaps to promote further research. This Review discusses how the maternal gut microbiome in pregnancy influences the developing immune system and proposes avenues for future research. Key points Microbiota–host interactions during pregnancy are key for maternal and neonatal health outcomes and healthy offspring development. Little is known regarding how the maternal microbiota and metabolites shape the maternal–fetal immune system during pregnancy. Limited information is available on the factors that contribute to maternal microbiota–immune system feedback during pregnancy and early lactation. Prenatal and postnatal immune system–microbiome interactions are relevant for human health. The role of breast milk compounds in neonatal immune system development and microbial assembly warrants further studies.