Publications

BACKGROUND: The infant gut microbiome is essential for healthy growth and development. However, limited research has explored how interventions targeting  maternal and infant health, nutrition, and psychosocial conditions during  preconception, pregnancy, and early childhood impact microbiome development. To  address this research gap and better understand the potential impact of such  interventions, this study was designed to evaluate their effects on the infant  gut microbiome. OBJECTIVE: The aim was to evaluate the effects of an integrated  intervention package on infant gut microbiome at 6 mo of age compared with  routine care. METHODS: The study was embedded in a randomized factorial trial  involving women aged 18-30 y. Participants were randomly assigned to receive  either a preconception intervention package or routine care until pregnancy.  Pregnant women were then randomly assigned to receive a pregnancy and early  childhood intervention package or routine care. The intervention included health  care for growth-related conditions, nutrition, water, sanitation, and hygiene  (WASH), and psychosocial care. Stool samples from 392 infants (185 from the  preconception, pregnancy, and early childhood intervention group and 207 from the  routine care group) were collected at 6 mo, followed by microbiome DNA isolation  and high-throughput sequencing of the V3-V4 region of 16S rRNA gene. Generalized  linear models were used to estimate the mean relative abundance of core gut  microbiome phyla, genera, and species between the intervention and routine care  groups. RESULTS: Infants in the group who received preconception, pregnancy, and  early childhood intervention had a significantly lower mean relative abundance of  Klebsiella genus under the Pseudomonadota phylum (45% lower; 95% confidence  interval [CI]: 18, 63) and Klebsiella pneumoniae species (38% lower; 95% CI: 8,  59) compared with routine care group. In contrast, the relative abundance of  Megasphaera (72% higher; 95% CI: 7, 175), Prevotella (72% higher; 95% CI: 3,  187), and Bifidobacterium breve (34% higher; 95% CI: 2, 79) was significantly  higher in the group received preconception, pregnancy and early childhood  intervention compared with routine care. CONCLUSIONS: The findings indicate that  improving maternal and infant health, nutrition, and psychosocial conditions  enhances the relative abundance of beneficial gut bacteria at 6 mo of age,  supporting healthy growth and development. This trial was registered at Clinical  Trials Registry-India as CTRI/2020/10/028770;  https://ctri.nic.in/Clinicaltrials/advsearch2.php.