Maternal fecal microbiome predicts gestational age, birth weight and neonatal growth in rural Zimbabwe.
Ethan K. Gough,
Thaddeus J. Edens,
Hyun Min Geum,
Iman Baharmand,
Sandeep K. Gill,
Ruairi C. Robertson,
Kuda Mutasa,
Robert Ntozini,
Laura E Smith,
Bernard Chasekwa,
Florence D. Majo,
Naume V. Tavengwa,
Batsirai Mutasa,
Freddy Francis,
Lynnea Carr,
Joice Tome,
Rebecca J. Stoltzfus,
Lawrence H. Moulton,
Andrew J. Prendergast,
Jean H. Humphrey,
Amee R. Manges,
SHINE Trial Team
Affiliations
Ethan K. Gough
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Corresponding author: Amee R. Manges, MPH, PhD, School of Population and Public Health, University of British Columbia, 137-2206 East Mall, Vancouver, BC Canada
Thaddeus J. Edens
Devil's Staircase Consulting, West Vancouver, British Columbia, Canada; Corresponding author: Amee R. Manges, MPH, PhD, School of Population and Public Health, University of British Columbia, 137-2206 East Mall, Vancouver, BC Canada
Hyun Min Geum
School of Population and Public Health, University of British Columbia, Vancouver, Canada
Iman Baharmand
School of Population and Public Health, University of British Columbia, Vancouver, Canada
Sandeep K. Gill
School of Population and Public Health, University of British Columbia, Vancouver, Canada
Ruairi C. Robertson
Blizard Institute, Queen Mary University of London, London, UK
Kuda Mutasa
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Robert Ntozini
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Laura E Smith
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Department of Population Medicine and Diagnostics, Cornell University, Ithaca, NY, USA
Bernard Chasekwa
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Florence D. Majo
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Naume V. Tavengwa
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Batsirai Mutasa
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Freddy Francis
Department of Experimental Medicine, University of British Columbia, Canada
Lynnea Carr
Department of Microbiology and Immunology, University of British Columbia, Canada
Joice Tome
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Rebecca J. Stoltzfus
Goshen College, Goshen, Indiana, USA
Lawrence H. Moulton
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Andrew J. Prendergast
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
Jean H. Humphrey
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Blizard Institute, Queen Mary University of London, London, UK
Amee R. Manges
School of Population and Public Health, University of British Columbia, Vancouver, Canada; British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
SHINE Trial Team
Members of the SHINE Trial team who are not named authors are listed in https://academic.oup.com/cid/article/61/suppl_7/S685/358186
Background: Preterm birth and low birth weight (LBW) affect one in ten and one in seven livebirths, respectively, primarily in low-income and middle-income countries (LMIC) and are major predictors of poor child health outcomes. However, both have been recalcitrant to public health intervention. The maternal intestinal microbiome may undergo substantial changes during pregnancy and may influence fetal and neonatal health in LMIC populations. Methods: Within a subgroup of 207 mothers and infants enrolled in the SHINE trial in rural Zimbabwe, we performed shotgun metagenomics on 351 fecal specimens provided during pregnancy and at 1-month post-partum to investigate the relationship between the pregnancy gut microbiome and infant gestational age, birth weight, 1-month length-, and weight-for-age z-scores using extreme gradient boosting machines. Findings: Pregnancy gut microbiome taxa and metabolic functions predicted birth weight and WAZ at 1 month more accurately than gestational age and LAZ. Blastoscystis sp, Brachyspira sp and Treponeme carriage were high compared to Western populations. Resistant starch-degraders were important predictors of birth outcomes. Microbiome capacity for environmental sensing, vitamin B metabolism, and signalling predicted increased infant birth weight and neonatal growth; while functions involved in biofilm formation in response to nutrient starvation predicted reduced birth weight and growth. Interpretation: The pregnancy gut microbiome in rural Zimbabwe is characterized by resistant starch-degraders and may be an important metabolic target to improve birth weight. Funding: Bill and Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Agency for Development and Cooperation, US National Institutes of Health, and UNICEF.
