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Epidemiology and population health

Does birth mode modify associations of maternal pre-pregnancy BMI and gestational weight gain with the infant gut microbiome?

Abstract

Background:

Mother-to-newborn transmission of obesity-associated microbiota may be modified by birth mode (vaginal vs. Cesarean delivery). Prospective data to test this hypothesis are still sparse.

Objective:

To examine prospective associations of maternal pre-pregnancy BMI and gestational weight gain with the infant gut microbiome by birth-mode strata.

Subjects/Methods:

In 335 mother–infant pairs in the New Hampshire Birth Cohort, we ascertained data from questionnaires and medical records, and generated microbiome data from 6-week-old infants’ stool using Illumina 16s rRNA gene sequencing (V4–V5 region). Analyses were stratified by birth mode and conducted before and after adjusting for potential confounders, which included maternal age, education, parity, and Mediterranean diet score.

Results:

Among 335 mothers, 56% had normal pre-pregnancy BMI ( < 25, referent), 27% were overweight (BMI 25–30), and 18% obese (BMI > 30). Among the 312 mothers with weight gain data, 10% had inadequate weight gain, 30% adequate (referent), and 60% excess. Birth mode modified associations of pre-pregnancy BMI with several genera, including the most abundant genus, Bacteroides (P for interaction = 0.05). In the vaginal-delivery group, maternal overweight or obesity was associated with higher infant gut microbiome diversity and higher relative abundance of 15 operational taxonomic units (OTUs), including overrepresentation of Bacteroides fragilis, Escherichia coli, Veillonella dispar, and OTUs in the genera Staphylococcus and Enterococcus. In the Cesarean-delivered group, there were no significant associations of pre-pregnancy BMI with infant microbiome (alpha) diversity or OTUs. Gestational weight gain was not associated with differential relative abundance of infant gut microbial OTUs or with measures of microbial diversity in infants delivered vaginally or by Cesarean section.

Conclusions:

Among vaginally-delivered infants, maternal overweight and obesity was associated with altered infant gut microbiome composition and higher diversity. These associations were not observed in Cesarean-delivered infants, whose microbiome development differs from vaginally-delivered infants. Our study provides additional evidence of birth-mode dependent associations of maternal body weight status with the infant gut microbiota. The role of these associations in mediating the intergenerational cycle of obesity warrants further examination.

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Acknowledgements

We would like to extend our sincerest gratitude to the participants of the New Hampshire Birth Cohort. Furthermore, we would like to thank Michael S. Zens, and John Hudson for their unending patience and extensive technological help.

Funding

Research reported in this publication was supported by The Mid-Atlantic Nutrition Obesity Research Center (NORC) under NIH award number P30DK072488. Research reported in this publication was also supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K01HL141589 (PI: Mueller), National Institutes of Health (grants NIGMS P20GM104416 (Karagas), NIEHS P01ES022832 (Karagas), NLM K01LM011985 (Hoen), NLM R01LM012723 (Hoen), the US Environmental Protection Agency (RD83544201) (Karagas).

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Conflict of interest

The authors declare that they have no conflict of interest.

Correspondence to Noel T. Mueller.

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