Ma Liang Kun, Xue Yong, He Ting Chao, Zhang Yu Mei
Department of Obstetrics & Gynecology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
CAS Key Laboratory of Pathogenic Microbiology and Immunology,Institute of Microbiology,Chinese Academy of Science,Beijing 100101,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Oct 30;40(5):630-636. doi: 10.3881/j.issn.1000-503X.10505.
Objective To investigate the associations of socioeconomic factors,nutrients intake,and gut microbiota of healthy pregnant women in the third trimester with gestational weight gain (GWG).Methods We recruited 98 pregnant women in the third trimester who had received antenatal care in the Department of Obstetrics Gynecology,Peking Union Medical College Hospital from October,2015 to May,2016. We collected socioeconomic information through a structured questionnaire covering age,ethnicity,height,pre-pregnancy weight,and education. Nutritional status of these pregnant women was assessed by a 24-hour dietary intake recall. The participants were provided with collective tubes for faecal sample collection at home;their weight before the delivery was recorded. The pre-pregnancy weight and GWG were classified according to World Health Organization body mass index (BMI) standard for adults and the Institute of Medicine GWG guidelines (2009),respectively. The gut microbiota of the participants were analyzed using a whole-metagenome shotgun sequencing method.Results Insufficient and excessive GWG accounted for 15.3% and 50.0% of the cohort,respectively. Appropriate GWG level was associated with intakes of fat (F=3.113,P=0.049),carbohydrates (F=3.750,P=0.027),and dietary fiber (F=4.499,P=0.014) but not with age (F=2.495,P=0.088),ethnicity (Χ =0.065,P=0.968),education (Χ =0.827,P=0.661),or pre-pregnancy BMI (F=0.121,P=0.887). Compared with the participants with appropriate GWG,those with excessive GWG had significantly higher abundance of Akkermansia muciniphila,Atopobium parvulum,and Alistipes indistinctus as well as lower abundance of Lactobacillus rhamnosus,Weissella unclassified,Eubacterium ventriosum,Ruminococcus torques,and Bacteroides uniformis. Compared with the participants with appropriate GWG,those with insufficient GWG had significantly higher abundance of Dialister invisus,Alistipes unclassified,Peptoniphilus harei,Escherichia unclassified,Parvimonas unclassified,Campylobacter ureolyticus,Lactobacillus crispatus,and Fusobacterium nucleatum and lower abundance of Eubacterium ventriosum.Conclusions Abnormal GWG is common in pregnant women. GWG is significantly associated with gut microbiota as well as with nutritional factors including fat,carbohydrate,and dietary fiber intake.
目的 探讨孕晚期健康孕妇的社会经济因素、营养摄入及肠道微生物群与孕期体重增加（GWG）之间的关联。方法 我们招募了98例于2015年10月至2016年5月在北京协和医院妇产科接受产前检查的孕晚期孕妇。通过一份涵盖年龄、种族、身高、孕前体重和教育程度的结构化问卷收集社会经济信息。通过24小时饮食摄入量回顾评估这些孕妇的营养状况。为参与者提供在家收集粪便样本的集便管；记录她们分娩前的体重。孕前体重和GWG分别根据世界卫生组织成人身体质量指数（BMI）标准和美国医学研究所GWG指南（2009年）进行分类。使用全基因组鸟枪法测序方法分析参与者的肠道微生物群。结果 GWG不足和过多的孕妇分别占队列的15.3%和50.0%。适当的GWG水平与脂肪摄入量（F=3.113，P=0.049）、碳水化合物摄入量（F=3.750，P=0.027）和膳食纤维摄入量（F=4.499，P=0.014）相关，但与年龄（F=2.495，P=0.088）、种族（Χ =0.065，P=0.968）、教育程度（Χ =0.827，P=0.661）或孕前BMI（F=0.121，P=0.887）无关。与GWG适当的参与者相比，GWG过多的参与者嗜黏蛋白阿克曼氏菌、细小阿托波菌和模糊艾利斯菌的丰度显著更高，而鼠李糖乳杆菌、未分类魏斯氏菌、膨胀真杆菌、扭链瘤胃球菌和单形拟杆菌的丰度更低。与GWG适当的参与者相比，GWG不足的参与者不可见戴利斯特菌、未分类艾利斯菌、哈氏消化链球菌、未分类大肠杆菌、未分类细小单胞菌、解脲弯曲菌、卷曲乳杆菌和具核梭杆菌的丰度显著更高，而膨胀真杆菌的丰度更低。结论 GWG异常在孕妇中很常见。GWG与肠道微生物群以及包括脂肪、碳水化合物和膳食纤维摄入在内的营养因素显著相关。
