The Importance of the Gut Microbiome During Pregnancy

As more data emerges supporting the importance of the gut microbiome during pregnancy, the link between changes in the microbiota during pregnancy and impaired metabolism and GI function also continues to grow. A recent small trial adds to this knowledge base; 32 participants were given a probiotic containing multiple strains of Lactobacillus as well as B. lactis over a 16 day period. In this unblinded and uncontrolled trial, frequent survey questions were administered regarding quality of life as well as GI specific questions (e.g., nausea, vomiting), and fecal samples (providing data related to gut metabolites, microbiota, and bacterial genes) were obtained from the majority of participants.

Probiotic supplementation was associated with improvement in quality of life scores, as well as symptoms related to GI function, including nausea, vomiting, and constipation (i.e., softer consistency of stools). Also of significant interest, probiotic supplementation increased the copy number of the bile-acid producing gene bsh by nearly 6-fold. Bile salt hydrolase (encoded by bsh) deconjugates bile acids, and an increase in free bile acids is likely to increase bile acid receptor activity, an effect likely to influence both energy metabolism and intestinal motility. Although this was a small and unblinded/controlled trial, it suggests a new potential mechanism by which probiotics may help with intestinal function as well as symptoms during pregnancy, and may provide a pathway for previously documented benefits of probiotics related to inflammation and gestational diabetes.