(P27-016-24) Maternal Fortified Balanced Energy-Protein Supplementation Increases Diversity of the Maternal Gut Microbiome and the Capacity of Carbohydrate Uptake in Infant Gut

Objectives: Over 20% of the global population under age 5 experienced stunted growth in 2022. Maternal balanced energy-protein (BEP) supplementation is used to support infant growth, but the response of the microbiome to such supplementation remains largely unexplored, particularly in low- and middle-income countries. The objective of this study is to evaluate the effect of maternal BEP supplementation on the composition and functionality of the gut microbiome in mother-infant dyads in rural Burkina Faso.

Methods: We conducted a randomized controlled trial in rural Burkina Faso, among pregnant women (15-40 years old) enrolled at < 21 weeks of gestation. In the intervention group women received BEP supplements throughout pregnancy and the first six months postpartum. Fecal samples were collected from women and their infants at multiple timepoints covering pregnancy and lactation, and were analyzed using deep metagenomic sequencing.

Results: A total of 731 fecal samples from 152 women and their infants were collected and sequenced, which comprised 475 maternal samples and 256 infant samples. The maternal gut microbiota exhibited a conspicuous dominance of Prevotella species, while Bifidobacterium strains were dominant in infant samples. BEP supplementation significantly increased microbiome diversity during pregnancy, with a decrease in the abundance of an Oscillospiraceae species in the second trimester and an increase in Bacteroides fragilis at 5-6 months postpartum in women. We identified concerted enriched or depleted microbial pathways associated with BEP supplementation, including the biosynthesis of lipopolysaccharide, a factor triggering preterm labor, were depleted within the prenatal gut microbiome in women who received BEP supplements. Furthermore, the phosphotransferase system, a critical mechanism for bacterial carbohydrate uptake, exhibited enrichment in infants born to BEP-supplemented mothers.

Conclusions: Overall, our results shed light on gut microbiome dynamics in a population that is underrepresented in microbiome science. The impact of maternal BEP supplementation on the maternal and infant's gut microbiome may benefit the growth of fetuses and neonates.

Funding Sources: This work is supported by the Bill & Melinda Gates Foundation.