Moms-to-be: Mortality risk is linked to mother’s vaginal microbiome

Researchers from the University of Maryland School of Medicine found that an unhealthy vaginal microbiota in pregnant moms, combined with an unhealthy diet, resulted in pup deaths and disrupted development in the surviving infants in a recent mouse study. Babies are exposed to their mother’s vaginal microbiome when they travel through the birth canal, when their skin is coated and they consume their first microbiome outside the sterile womb.

Infant and mother mortality rates

Infant mortality occurs when a child dies before reaching his or her first birth date. Great progress has been made in lowering infant and maternal fatalities in recent decades. However, newborns and mothers, including adolescent moms, continue to die in unacceptable numbers, largely due to preventable or treatable reasons including infectious illnesses and problems during pregnancy or childbirth. Around 7,000 newborns die every day in their first month of life. Worldwide, an estimated 2.4 million infants died in 2019. Every day, approximately 810 women die from preventable complications related to pregnancy or childbirth around the world. Between 2020 and 2030, 48 million children under the age of five are expected to die, with half of them being newborns, if current trends continue. In the United States, there are three regularly used metrics of maternal fatalities. They are not interchangeable, even if they all capture some aspect of maternal fatalities.

Pregnancy-associated death is defined as death that occurs while pregnant or within one year after the conclusion of the pregnancy, regardless of the reason.

Pregnancy-related death occurs when a woman dies during pregnancy or within one year of giving birth as a result of a pregnancy complication, a chain of events triggered by pregnancy, or the physiologic effects of pregnancy aggravating an unrelated ailment. This CDC statistic is normally given as a ratio per 100,000 births and is solely used in the United States.

Maternal mortality is defined as death while pregnant or within 42 days after delivery, regardless of the length or location of the pregnancy, from any cause connected to or aggravated by the pregnancy or its management, but excluding unintentional or incidental causes. This statistic is published as a ratio per 100,000 births by the World Health Organization (WHO) for worldwide comparisons.

Mother’s diet

Diet is a critical influencer of population health among environmental factors. Most adult-onset diseases, according to the developmental origins of health and illness concept, have their origins in fetal life. Pregnancy is a particularly “hot period” for future condition programming. The link between a mother’s nutrition and adverse pregnancy outcomes such as preeclampsia, hypertension, preterm birth, and fertility has also been discovered.

Supplemental iron and folate doses may be provided on a daily or irregular basis. Vitamin A supplementation should be limited to places where vitamin A deficiency is a significant public health hazard. Calcium supplementation is only recommended for people who have a low calcium intake. Supplementing with vitamin B6, zinc, multi-nutrient supplements, and vitamin D is not recommended as a routine treatment. Caffeine should be avoided by ladies who consume a lot of it.

A well-balanced diet should include a variety of foods including

Legumes and vegetables
Cereals and breads
Fruit
Milk, yogurt, and cheese
Meat, poultry, and fish

Infant microbiome

Millions of microorganisms reside on and in the human body, and they work together with our own cells to affect health outcomes over the lifespan—and perhaps across generations. These microorganisms are known as “microbiota” (organisms) or “microbiome” (the organisms and their collective genetic makeup).

The gut microbiota has an impact on immunological, endocrine, and neurological pathways, as well as newborn development. The colonization of the baby’s gut microbiome is influenced by a number of variables. Vaginal versus surgical delivery, antibiotic exposure, and infant feeding practices are all linked to different microbial colonization patterns. Infant microbial colonization patterns have the ability to affect physical and neurocognitive development, as well as disease risk throughout time, due to their vast physiological influence.

Impact of mother’s vaginal microbiome on newborn mortality and development

During vaginal birth, the vaginal microbiota serves as a key mother microbial reservoir for the colonization of the infant. In contrast to the gut microbiome, the vaginal microbiota in women of reproductive age is made up of minimally diversified communities that are separated into five distinct community state types (CST). Lactobacillus species predominate in CST I, II, III, and V, which represent the most prevalent communities in the cervicovaginal region. The absence of Lactobacillus and the presence of anaerobic bacteria, such as Snethia, Prevotella, Megasphaera, Gardnerella vaginalis, and Atopobium vaginae, constitute another vaginal community state type, CST IV.

Lactobacillus crispatus, G. vaginalis, and A. vaginae, among other maternal vaginal bacteria, are among the first colonizers to remain within the infant digestive system within the first few days after birth, according to strain-resolved analysis. While these CST I (L. crispatus) and CST IV (G. vaginalis, A. vaginae) members of the female reproductive tract have distinct metabolic and immunological properties, the physiological ramifications of transmitting these communities from mother to infant are unknown.

A new study in mice found that an unhealthy vaginal microbiota in pregnant moms, combined with a bad diet, resulted in more pup deaths and delayed development of the infants who survived. The moms were given a healthier diet to help offset the mortality caused by the unhealthy vaginal microbiome. According to the researchers, their findings could signal that modest treatments, such as access to a diet high in fiber-rich fruits and vegetables, could help mitigate some of the negative effects an unhealthy microbiome can have on human offspring, especially in underprivileged groups.

Babies are exposed to their mother’s vaginal microbiome when they travel through the birth canal, when their skin is coated and they consume their first microbes outside the sterile womb.

Women who have diabetes or high blood pressure, as well as those who live in low-income areas with inadequate access to healthcare and nutrition, are more likely to have an unhealthy vaginal microbiome. These unhealthy vagina microbiomes contain an excessive number of bacteria, viruses, and yeast, which, unlike in the gut, is a bad thing in the vagina, raising the risk of infection.

Researchers used vaginal microbiota samples from pregnant mothers, in their C-section mouse model. To mimic the prenatal environment, they first injected either healthy or unhealthy bacterial samples into the mouse’s vagina. The pups born via C-section were then given identical vaginal microbiomes, simulating vaginal birth. The researchers looked into which genes were turned on and off in the pups’ brains to examine how the mothers’ vaginal microorganisms influenced the development of their offspring. They discovered that these puppies’ immune systems were activated and developing at a young age.

The researchers looked into which genes were turned on and off in the pups’ brains to examine how the mothers’ vaginal microorganisms influenced the development of their offspring. They discovered that these puppies’ immune systems were activated and developed at a young age. The death rate was reduced by more than half when the same microbiome exposure was combined with a healthy high-fiber diet.

Through fetal immune system development, the vaginal microbiome component led to profound alterations in the brain, and it appears that this overactive immune system raises the chance of infant mortality. These associations were observed in humans with unhealthy vaginal microbiomes; research is now going on to identify the mechanisms that can affect outcomes of pregnancy, possibly as novel biomarkers to identify women at risk.

These research works assist to lay the groundwork for what interventions might be evaluated to promote health and wellbeing and lower infant mortality rates.