Maternal Microbiome and Infections in Pregnancy

Abstract

Pregnancy induces unique changes in maternal immune responses and metabolism. Drastic physiologic adaptations, in an intricately coordinated fashion, allow the maternal body to support the healthy growth of the fetus. The gut microbiome plays a central role in the regulation of the immune system, metabolism, and resistance to infections. Studies have reported changes in the maternal microbiome in the gut, vagina, and oral cavity during pregnancy; it remains unclear whether/how these changes might be related to maternal immune responses, metabolism, and susceptibility to infections during pregnancy. Our understanding of the concerted adaption of these different aspects of the human physiology to promote a successful pregnant remains limited. Here, we provide a comprehensive documentation and discussion of changes in the maternal microbiome in the gut, oral cavity, and vagina during pregnancy, metabolic changes and complications in the mother and newborn that may be, in part, driven by maternal gut dysbiosis, and, lastly, common infections in pregnancy. This review aims to shed light on how dysregulation of the maternal microbiome may underlie obstetrical metabolic complications and infections.

Keywords: gut microbiome; infection; metabolism; pregnancy.

Figure 1

General changes in the gut, oral, and vaginal microbiomes in parallel with the hormonal changes throughout pregnancy. The changes that occur in the gut throughout pregnancy are complex and mediated by maternal factors, such as diet and antibiotic usage. The vaginal microbiome during pregnancy becomes more stably dominated by species of Lactobacillus, thereby decreasing in overall diversity.