Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (01): 116 -120. doi: 10.3877/cma.j.issn.1673-5250.2019.01.020

Special Issue:

Review

Research progress on effects of maternal intestinal flora disturbance and its intrauterine translocation on mother and fetus

Lijuan Lyu1, Hui Li1, Wei He1, Hongli Duan1, Aihua Yin1,()   

  1. 1. Department of Obstetrics, Guangdong Women′s and Children′s Hospital, Guangzhou 511400, Guangdong Province, China
  • Received:2018-09-08 Revised:2019-01-03 Published:2019-02-01
  • Corresponding author: Aihua Yin
  • About author:
    Corresponding author: Yin Aihua, Email:
  • Supported by:
    Key Project for Prevention and Control of Reproductive Health and Major Birth Defects of National Key Research and Development Program of China in 2016(2016YFC1000703)

Recent studies have shown that bacteria exist in the uterus and may affect the fetus. So far, the specific mechanism of flora translocation between mother and fetus has not been clarified. Besides maternal blood, placenta and amniotic fluid, maternal intestinal tract may also be one of the main sources of fetal intestinal flora. The maternal intestinal flora is translocated to the uterus through blood and other means, and then translocated to the fetal gut and immune system via the placental blood circulation and amniotic fluid. The abnormal composition and quantity of intestinal flora during pregnancy can lead to obesity, abnormal development of nerve system and abnormal blood pressure regulation of the mother and fetus after birth. With the development of gene sequencing technology, the relationship between maternal intestinal flora disturbance and its intrauterine translocation and maternal-fetal diseases can be further explored, thus providing theoretical basis for prevention and intervention of fetal diseases. The author intends to review the research progress on the effects of maternal intestinal flora disturbance and its intrauterine translocation on the mother and fetus.

[1]
Romano-Keeler J, Weitkamp JH. Maternal influences on fetal microbial colonization and immune development [J]. Pediatr Res, 2015, 77(1-2): 189-195.
[2]
Charbonneau MR, Blanton LV, DiGiulio DB, et al. A microbial perspective of human developmental biology [J]. Nature, 2016, 535(7610): 48-55.
[3]
Dominguez-Bello MG, Costello EK, Contreras M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns [J]. Proc Natl Acad Sci U S A, 2010, 107(26): 11971-11975.
[4]
Pluznick JL, Protzko RJ, Gevorgyan H, et al. Olfactory receptor responding to gut microbiota-derived signals plays a role in renin secretion and blood pressure regulation [J]. Proc Natl Acad Sci U S A, 2013, 110(11): 4410-4415.
[5]
Jiménez E, Fernández L, Marín ML, et al. Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section [J]. Curr Microbiol, 2005, 51(4): 270-274.
[6]
Rautava S, Collado MC, Salminen S, et al. Probiotics modulate host-microbe interaction in the placenta and fetal gut: a randomized, double-blind, placebo-controlled trial [J]. Neonatology, 2012, 102(3): 178-184.
[7]
Jiménez E, Marín ML, Martín R, et al. Is meconium from healthy newborns actually sterile? [J]. Res Microbiol, 2008, 159(3): 187-193.
[8]
Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms [J]. J Periodontol, 2013, 84(4 Suppl): S170-S180.
[9]
Thum C, Cookson AL, Otter DE, et al. Can nutritional modulation of maternal intestinal microbiota influence the development of the infant gastrointestinal tract? [J]. J Nutr, 2012, 142(11): 1921-1928.
[10]
Jeon SJ, Cunha F, Vieira-Neto A, et al. Blood as a route of transmission of uterine pathogens from the gut to the uterus in cows [J]. Microbiome, 2017, 5(1): 109.
[11]
Perez PF, Doré J, Leclerc M, et al. Bacterial imprinting of the neonatal immune system: lessons from maternal cells? [J]. Pediatrics, 2007, 119(3): e724-e732.
[12]
Abrahamsson TR, Wu RY, Jenmalm MC. Gut microbiota and allergy: the importance of the pregnancy period [J]. Pediatr Res, 2015, 77(1-2): 214-219.
[13]
Perry RJ, Peng L, Barry NA, et al. Acetate mediates a microbiome-brain-β-cell axis to promote metabolic syndrome [J]. Nature, 2016, 534(7606): 213-217.
[14]
Ma J, Prince AL, Bader D, et al. High-fat maternal diet during pregnancy persistently alters the offspring microbiome in a primate model [J]. Nat Commun, 2014, 5: 3889.
[15]
Koh A, De Vadder F, Kovatcheva-Datchary P, et al. From dietary fiber to host physiology: short-chain fatty acids as key bacterial metabolites [J]. Cell, 2016, 165(6): 1332-1345.
[16]
Borre YE, O′Keeffe GW, Clarke G, et al. Microbiota and neurodevelopmental windows: implications for brain disorders [J]. Trends Mol Med, 2014, 20(9): 509-518.
[17]
Hsiao EY, McBride SW, Hsien S, et al. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders [J]. Cell, 2013, 155(7): 1451-1463.
[18]
Choi GB, Yim YS, Wong H, et al. The maternal interleukin-17a pathway in mice promotes autism-like phenotypes in offspring [J]. Science, 2016, 351(6276): 933-939.
[19]
Kim S, Kim H, Yim YS, et al. Maternal gut bacteria promote neurodevelopmental abnormalities in mouse offspring [J]. Nature, 2017, 549(7673): 528-532.
[20]
Shin Yim Y, Park A, Berrios J, et al. Reversing behavioural abnormalities in mice exposed to maternal inflammation [J]. Nature, 2017, 549(7673): 482-487.
[21]
Ivanov II, Atarashi K, Manel N, et al. Induction of intestinal Th17 cells by segmented filamentous bacteria [J]. Cell, 2009, 139(3): 485-498.
[22]
Buffington SA, Di Prisco GV, Auchtung TA, et al. Microbial reconstitution reverses maternal diet-induced social and synaptic deficits in offspring [J]. Cell, 2016, 165(7): 1762-1775.
[23]
Li J, Zhao F, Wang Y, et al. Gut microbiota dysbiosis contributes to the development of hypertension [J]. Microbiome, 2017, 5(1): 14.
[24]
Cani PD, Amar J, Iglesias MA, et al. Metabolic endotoxemia initiates obesity and insulin resistance [J]. Diabetes, 2007, 56(7): 1761-1772.
[25]
Gomez-Arango LF, Barrett HL, McIntyre HD, et al. Increased systolic and diastolic blood pressure is associated with altered gut microbiota composition and butyrate production in early pregnancy [J]. Hypertension, 2016, 68(4): 974-981.
[26]
Liu J, Yang H, Yin Z, et al. Remodeling of the gut microbiota and structural shifts in preeclampsia patients in South China [J]. Eur J Clin Microbiol Infect Dis, 2017, 36(4): 713-719.
[27]
Brantsaeter AL, Myhre R, Haugen M, et al. Intake of probiotic food and risk of preeclampsia in primiparous women: the Norwegian Mother and Child Cohort Study [J]. Am J Epidemiol, 2011, 174(7): 807-815.
[28]
Myhre R, Brantsæter AL, Myking S, et al. Intake of probiotic food and risk of spontaneous preterm delivery [J]. Am J Clin Nutr, 2011, 93(1): 151-157.
[29]
Cho NH, Silverman BL, Rizzo TA, et al. Correlations between the intrauterine metabolic environment and blood pressure in adolescent offspring of diabetic mothers [J]. J Pediatr, 2000, 136(5): 587-592.
[30]
Vatten LJ, Romundstad PR, Holmen TL, et al. Intrauterine exposure to preeclampsia and adolescent blood pressure, body size, and age at menarche in female offspring [J]. Obstet Gynecol, 2003, 101(3): 529-533.
[31]
Gohir W, Ratcliffe EM, Sloboda DM, et al. Of the bugs that shape us: maternal obesity, the gut microbiome, and long-term disease risk [J]. Pediatr Res, 2015, 77(1-2): 196-204.
[32]
Santisteban MM, Qi Y, Zubcevic J, et al. Hypertension-linked pathophysiological alterations in the gut [J]. Circ Res, 2017, 120(2): 312-323.
[33]
Mowat AM, Agace WW. Regional specialization within the intestinal immune system [J]. Nat Rev Immunol, 2014, 14(10): 667-685.
[34]
Brugman S, Perdijk O, van Neerven RJ, et al. Mucosal immune development in early life: setting the stage [J]. Arch Immunol Ther Exp (Warsz), 2015, 63(4): 251-268.
[35]
Milani C, Duranti S, Bottacini F, et al. The first microbial colonizers of the human gut: composition, activities, and health implications of the infant gut microbiota [J]. Microbiol Mol Biol Rev, 2017, 81(4): e00036-17.
[36]
Perez-Muñoz ME, Arrieta MC, Ramer-Tait AE, et al. A critical assessment of the " sterile womb" and " in utero colonization" hypotheses: implications for research on the pioneer infant microbiome [J]. Microbiome, 2017, 5(1): 48.
[37]
Houghteling PD, Walker WA. Why is initial bacterial colonization of the intestine important to infants′ and children′s health? [J]. J Pediatr Gastroenterol Nutr, 2015, 60(3): 294-307.
[38]
Hill DR, Huang S, Nagy MS, et al. Bacterial colonization stimulates a complex physiological response in the immature human intestinal epithelium [J]. Elife, 2017, 6. pii: e29132.
[39]
Duan J, Chung H, Troy E, et al. Microbial colonization drives expansion of IL-1 receptor 1-expressing and IL-17-producing gamma/delta T cells [J]. Cell Host Microbe, 2010, 7(2): 140-150.
[40]
Abecia L, Jiménez E, Martínez-Fernandez G, et al. Natural and artificial feeding management before weaning promote different rumen microbial colonization but not differences in gene expression levels at the rumen epithelium of newborn goats [J]. PLoS One, 2017, 12(8): e0182235.
[41]
Laforest-Lapointe I, Arrieta MC. Patterns of early-life gut microbial colonization during human immune development: an ecological perspective [J]. Front Immunol, 2017, 8: 788.
[42]
Pickard JM, Zeng MY, Caruso R, et al. Gut microbiota: Role in pathogen colonization, immune responses, and inflammatory disease [J]. Immunol Rev, 2017, 279(1): 70-89.
[43]
Choi YS, Song IG. Fetal and preterm infant microbiomes: a new perspective of necrotizing enterocolitis [J]. Korean J Pediatr, 2017, 60(10): 307-311.
[44]
Gomez-Arango LF, Barrett HL, McIntyre HD, et al. Contributions of the maternal oral and gut microbiome to placental microbial colonization in overweight and obese pregnant women [J]. Sci Rep, 2017, 7(1): 2860.
[45]
Qian LJ, Kang SM, Xie JL, et al. Early-life gut microbial colonization shapes Th1/Th2 balance in asthma model in BALB/c mice [J]. BMC Microbiol, 2017, 17(1): 135.
[1] Jinmei He, Lixue Yin, Jing Tan, Wenjun Zhang, Rui Wang, Mei Ren, Mingjiao Liao. Evaluation of potential left ventricular systolic dysfunction in patients with type 2 diabetes mellitus using ultrasonic myocardial work technology[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1029-1035.
[2] Xining Wu, Yunshu Ouyang, Yixiu Zhang, Hua Meng, Zhonghui Xu, Peipei Zhang, Ke Lyu. Application of fetal echocardiography in prenatal management of fetuses with positive maternal anti-SSA/Ro-SSB/La antibodies[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1056-1060.
[3] Shuihua Yang, Guidan He, Guican Qin, Mengfeng Liang, Yanhe Luo, Xueqin Li, Juansong Tang. Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1061-1067.
[4] Jingjing Zhang, Bowen Zhao, Mei Pan, Xiaohui Peng, Yankai Mao, Chenke Pan, Lingyan Zhu, Linlin Zhu, Qiuye Lan. Evaluation of fetal pulmonary development using McGoon index measured by fetal echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 860-865.
[5] Peng Xu, Jun Li, Weilun Gao, Zheng Wang, Shen Pang, Chunni Li, Ting Zhu. Application of fast rotary scanning method in fetal echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 761-766.
[6] Gang Luo, Silin Pan, Taotao Chen, Qian Xu, Zhixian Ji, Sibao Wang, Lingyu Sun. Application of echocardiography in fetal cardiac intervention of pulmonary atresia with intact ventricular septum[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 605-609.
[7] Jia Huang, Hua Shi, Yuguo Zhang, Jiaqi Hu, Qian Chen. Ultrasonographic features of normal and abnormal fetal left brachiocephalic vein and their clinical significance[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 610-617.
[8] Ze Yuan, Li Zhuang. Value of ultrasound detection of fetal umbilical artery and middle cerebral artery blood flow in diagnosis of fetal intrauterine distress[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 618-621.
[9] Tiantian Chen, Xiaodong Wang, Haiyan Yu. Pregnancy outcome of twin pregnancy with Gitelman syndrome: a case report and literature review[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 559-568.
[10] Xiaoqing Ju, Yunjie Jin, Xiaoyan Wang. Influencing factors of uterine rupture during vaginal delivery in patients with scarred uterus after cesarean section[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 575-581.
[11] Beibei Wang, Qixiu Dong, Hongyan Xi, Qingyun Yu, Lijun Zhang, Guang Shi. Analysis of influencing factors of medical abortion failure of pregnant women in early pregnancy and construction of related prediction model and its predictive value for medical abortion success[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 588-594.
[12] Xu Chen, Yuru Zhan, Chunhua Wang. Clinical value of ABO blood group combined with thyroid function in prediction of gestational diabetes mellitus[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 604-610.
[13] Mengling Zhou, Zhiwei Xue, Shu Zhou. Changes in size of uterine myoma during pregnancy and its association with adverse pregnancy outcomes[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 611-615.
[14] Kailun Ji, Shaolong Hao, Haitao Sun, Wei Han. New progress of gallstone formation mechanism after weight loss[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 100-103.
[15] Damin Chen, Xiaogang Cao, Nengqi Cao. Effect of obesity on surgical treatment of gastric cancer patients[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 651-653.
Viewed
Full text


Abstract