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The prospective large-scale, longitudinal birth cohort study MOMmy (MOther-infant Microbiota transmission and its link to long terM health of babY), conducted by The Chinese University of Hong Kong (CUHK)’s Faculty of Medicine (CU Medicine), aims to examine the gut microbiota of pregnant mothers and babies to assess how early-life exposure can affect the child’s lifelong health and be harnessed to predict, prevent and treat disease. For the first time, the research team presented the gut microbiome trajectory of mothers with gestational diabetes mellitus (GDM) throughout pregnancy and of infants during the first year of life. Results showed that mothers with GDM history have a distinct microbiome diversity and composition during the gestation period, and GDM leaves fingerprints on the infant’s gut microbiome for up to 12 months of age. The altered gut microbiome of infants born to GDM mothers is associated with a larger head circumference which relates to early life neurodevelopment. Findings have been published in the international journal Cell Host & Microbe.

GDM is associated with maternal and infant microbiome composition change

GDM is one of the most common gestational complications and is associated with several problems in pregnancy, such as preeclampsia, preterm delivery and fetal macrosomia. GDM also raises the baby’s health risk in the long term.

Professor Lin Zhang, Assistant Professor of the Department of Medicine and Therapeutics at CU Medicine, said: “Through metagenomic sequencing of 1,566 stools of 264 Hong Kong mother-baby dyads from the MOMmy cohort, our team found that GDM mothers had lower gut microbiome diversity and lower abundance of commensal species Akkermansia muciniphila, Coprococcus eutactus and Enterorhabdus caecimuris, while having a higher abundance of potential pathogens Fusobacterium mortiferum. Their infants had a higher abundance of Clostridium from Firmicutes phylum in the gut during the first year of life.”

Professor Siew Ng, Croucher Professor in Medical Sciences at CU Medicine, Director of the Microbiota I-Center (MagIC) and New Cornerstone Investigator, added: “Our new findings suggest the abnormal growth in head circumference in male offspring of mothers with gestational diabetes may be an important indicator of neurodevelopmental disorders early in life. Future research is necessary to understand the long-term consequences of over-growth in these infants and whether microbiota modulation serves as a potential approach to mitigate and prevent these risks.”

CU Medicine pioneers early life microbiome research in Asia

CU Medicine launched MOMmy in 2019 with a multidisciplinary team consisting of gastroenterologists, obstetricians, paediatricians, microbiologists and other scientists, following the babies for up to seven years and collecting extensive clinical information and serial biological samples to analyse the gut microbiota of pregnant mothers and babies.  

Professor Francis Chan, Choh-Ming Li Professor of Medicine and Therapeutics and Director of the Centre for Gut Microbiota Research at CU Medicine, remarked: “Current understanding of the mother-to-infant microbiome is largely skewed by European and American birth cohorts, demographically distinct from Asian populations. Owing to lifestyle, diet and geographical factors, translation of those findings to Asian populations may be imprecise and lack generalisability.

The long-term aim of MOMmy is to establish a representative birth cohort of mothers and infants with intestinal microbial health and disease in China of different urbanisation levels. It will benefit in defining the development trajectory of the gut microbiome of healthy infants and young children in China, establishing early non-invasive screening methods for common infant diseases, and improving the gut microbiome to early intervene in the occurrence of diseases and improve disease symptoms.”

This study was funded by the Hong Kong government’s InnoHK initiative.