Maternal obesity during pregnancy leads to derangements in one-carbon metabolism and the gut microbiota: implications for fetal development and offspring wellbeing

Rubini, Eleonora; Schenkelaars, Nicole; Rousian, Melek; Sinclair, Kevin D.; Wekema, Lieske; Faas, Marijke M.; Steegers-Theunissen, Régine P.M.; Schoenmakers, Sam

Abstract

A healthy diet prior to and during pregnancy is beneficial in acquiring essential B vitamins involved in one-carbon metabolism, and to maintain a healthy gut microbiota. Each play important roles in fetal development, immune-system remodeling and pregnancy-nutrient acquisition. Evidence shows that there is a reciprocal interaction between the one-carbon metabolism and the gut microbiota, as dietary intake of B vitamins has been shown to influence the composition of the gut microbiota, and certain gut bacteria also synthesize B vitamins. This reciprocal interaction contributes to the individual's overall availability of B vitamins and, therefore, should be maintained in a healthy state during pregnancy. There is an emerging consensus that obese pregnant women often have derangements in one-carbon metabolism and gut dysbiosis, due to a high intake of nutritiously poor foods and a chronic systemic inflammatory state. For example, low folate and vitamin B12 in obese women coincide with the decreased presence of B vitamin-producing bacteria and increased presence of inflammatory-associated bacteria from around mid-pregnancy. These alterations are risk factors for adverse pregnancy outcomes, impaired fetal development, and disruption of fetal growth and microbiota formation; which may lead to potential long-term offspring metabolic and neurological disorders. Therefore, preconceptional and pregnant obese women may benefit from dietary and lifestyle counselling to improve their dietary nutrient intake, and from monitoring their B vitamin levels and gut microbiome by blood tests and microbiota stool samples. Additionally, there is evidence that some probiotic bacteria have folate biosynthetic capacity and could be used to treat gut dysbiosis. So, their use as intervention strategy for obese women holds potential and should be further investigated. Currently, there are many knowledge gaps concerning the relationship between one-carbon metabolism and the gut microbiota, and future research should focus on intervention strategies to counteract B vitamin deficiencies and gut dysbiosis in obese pregnant women; commencing with the use of probiotic and prebiotic supplements.

Citation

Rubini, E., Schenkelaars, N., Rousian, M., Sinclair, K. D., Wekema, L., Faas, M. M., Steegers-Theunissen, R. P., & Schoenmakers, S. (2022). Maternal obesity during pregnancy leads to derangements in one-carbon metabolism and the gut microbiota: implications for fetal development and offspring wellbeing. American Journal of Obstetrics and Gynecology, 227(3), 392-400. https://doi.org/10.1016/j.ajog.2022.04.013

• Journal Article Type: Article
• Acceptance Date: Apr 7, 2022
• Online Publication Date: Apr 19, 2022
• Publication Date: Sep 1, 2022
• Deposit Date: Apr 27, 2022
• Publicly Available Date: Apr 28, 2022
• Journal: American Journal of Obstetrics and Gynecology
• Print ISSN: 0002-9378
• Electronic ISSN: 1097-6868
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 227
• Issue: 3
• Pages: 392-400
• DOI: https://doi.org/10.1016/j.ajog.2022.04.013
• Keywords: Obstetrics and Gynecology
• Public URL: https://nottingham-repository.worktribe.com/output/7834605
• Publisher URL: https://www.ajog.org/article/S0002-9378(22)00285-X/fulltext