What can physiological changes during pregnancy — specifically, to maternal gut health — tell us about the future health of the child? New research from the Sloboda Lab at McMaster explores this question.

Led by Deborah Sloboda, a professor in the department of Biochemistry and Biomedical Sciences, the lab investigates how early-life adversity impacts fetal development, which in turn influences the risk of chronic disease later in life.

We spoke with Sloboda, who is also an associate member of the departments of Obstetrics, Gynecology, and Pediatrics, about her latest research, her work, and why pregnancy health is a “community-level responsibility.”

In your latest research, you found the maternal gut becomes more permeable during pregnancy, and that this permeability is further exacerbated with a high fat diet. Why is this significant?

In a non-pregnant context,  increased gut permeability has been linked to impaired metabolic function. This can happen, for example, when you eat a diet that is high in saturated fat.

In our mouse model, we found that the maternal gut became more permeable when the mice became pregnant — even when they were eating a healthy diet.

Although we don’t fully understand why gut permeability increases during healthy pregnancy, our study raises the possibility that some maternal physiological adaptations to pregnancy could be governed by gut function.

And it’s possible that the combined effects of pregnancy and changes in gut permeability could affect how the mother’s physiology adapts.

Whether this has long-term sustained impacts on maternal metabolism after birth is not known, but we do know that high fat diet-induced changes in pregnancy physiology are linked to childhood obesity and long-term risk of metabolic dysfunction in offspring.

Given that babies receive their gut microbiota from the mother during birth, what can maternal gut health and function tell us about the baby?

Since maternal physiology governs fetal and placental growth, keeping healthy before and during pregnancy will make sure that fetal and placental growth and development reaches full potential.

Maternal gut function and its microbial contents are not just important for the mother’s adaptation to pregnancy; they also play a critical role in shaping the initial colonization patterns of the baby’s gut microbiome.

The initial colonization of the gut can have long-lasting effects on a child’s digestive health and immune system.

Speaking more generally, what is the most fascinating aspect of your research on gut health and function?

What’s truly fascinating about our research on gut health and function is the discovery that pregnancy itself seems to impose a unique kind of pressure on maternal intestinal function, specifically by increasing permeability.

This finding is remarkable because, in a non-pregnant context, increased permeability is typically associated with metabolic disease, obesity, and a poor diet.

Yet, in the entirely normal physiological event of pregnancy, we observed this same increase in gut permeability. The “why” behind this phenomenon remains a mystery to us, but it has undoubtedly opened the door to a brand-new way of thinking about how mothers physiologically adapt to pregnancy.

This finding challenges existing paradigms and invites further exploration into the complex interplay between pregnancy, diet, and gut health.

How would you want your research on gut health to contribute to the national discussion and public awareness on this matter?

Until recently, our understanding of pregnancy was limited to hormonal changes. We primarily attributed pregnancy adaptations to sex hormones and the hormones and proteins produced by the placenta.

But now we know that the gut and the gut microbiome play some sort of role in the normal adaptations to pregnancy — and our new data suggest that gut permeability is similarly altered.

This shift in understanding is exciting because it offers new pathways of intervention when pregnancies are complicated by diseases like diabetes. Our findings emphasize that gut health is an important aspect of pregnancy.

I hope our research encourages a broader dialogue about the importance of gut health in maternal and child well-being. By highlighting new pathways, we open up possibilities for targeted interventions, preventive strategies, and personalized health-care approaches.

It’s an exciting frontier that invites both the medical community and the public to rethink how we approach pregnancy health, recognize the importance of the gut’s role, and consider the broader impacts on the lifelong health of both mother and child.

What advice would you give the public around maintaining a healthy gut from cradle to grave, given that it begins in the womb with maternal diet and health?

Maintaining overall health (which includes a healthy gut) is a multifaceted journey that starts even before birth with parental diet and health. We recognize that there is a lot of pressure put on women, especially during pregnancy.

We want to emphasize that (gut) health is not just an individual responsibility but a community-level responsibility. Personal behaviours such as breastfeeding, stress management, regular physical activity, hydration, and a diet rich in fibers are important to foster a healthy gut microbial ecosystem.

However, these are only part of the picture, and our health doesn’t hinge solely on personal choices; we are all impacted by social determinants of health.

It’s vital that societal and community support and policy interventions are in place to support individuals that are pregnant and those that intend on becoming pregnant. We need to advocate for an environment where health choices are accessible for everyone, without placing undue pressure solely on pregnant women and individuals.

It’s important to integrate both personal health behaviours and policy-driven efforts, and to focus on broader public health-promoting strategies for both gastrointestinal and overall well-being, across the lifespan.