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Does a Woman's Gut Flora Change When She Becomes Pregnant?

Pregnancy is one of the most profound experiences a woman can expect in her lifetime. Most women who have endured a pregnancy knows that it can have a dramatic effect on the body, resulting in weight gain, bad moods and anger, fatigue, and many more unpleasant symptoms. One aspect of pregnancy that has not been heavily researched until recently is how a mother-to-be’s gut flora changes as she brings a child to term.

In a 2012 study led by microbiologist Ruth Ley at Cornell University, fecal bacteria from 91 pregnant women were analyzed for microbial characteristics over the course of three trimesters. Findings showed that composition of the gut microbiota changes dramatically throughout a pregnancy. Third-trimester stools were associated with higher levels of inflammation, as well as poorer sugar metabolism when compared with first trimester samples.

Pregnancy and Changes in the Body

Throughout the course of a normal pregnancy, the body should be expected to undergo numerous changes, some of which are substantial. These include hormonal shifts, as well as metabolic and immunological changes that are viewed as hallmarks of most healthy pregnancies. An increase in body fat tends to occur early on, closely followed by a reduction in insulin sensitivity (correlated with a change in immune status).

In obese individuals, these and similar signs may point to problems that can be detrimental to long-term health. In a pregnant woman, however, these changes can actually be beneficial to the growth of the fetus, as well as preparing the mother’s body for lactation.

As of today, it’s unclear what causes reduced insulin sensitivity during pregnancy. For those who are obese and not pregnant, however, metabolic disease that leads to inflammation, further weight gain and other symptoms may be associated with the gut microbiota, which is typically affected by factors such as diet, genetics and the immune system.

While the bodily changes mentioned above are expected in most pregnancies, it wasn’t until the 2012 Cornell study that shed light on the relationship between pregnancy and gut microflora.

Trimester Differences 

As pregnancies are split up into trimesters, researchers at Cornell analyzed and compared stool samples from each trimester. During the first trimester, very little differentiation in gut microflora occurred. Trimesters two and three, however, caused significant changes in the gut microbiota -- namely, bacteria associated with good health actually dropped as each woman who participated in the study came to term, with inflammation and reduced insulin sensitivity reaching levels typically seen in those who have diabetes.  

Researchers also transferred samples of gut bacteria taken from each trimester to sterile mice. Amazingly, third trimester bacteria caused the mice to gain weight, have higher levels of inflammation and poorer sugar metabolism than mice who were introduced to bacteria from the first trimester of pregnancy.

The Importance of Maintaining Good Gut Health in Pregnancy

In this study, diet did not seem to play a major role in the outcome of the 2012 Cornell study. That said, there are many reasons why it’s wise to go into a pregnancy with a healthy, balanced gut.

Looking to keep your gut flora in check? Here are just a few tips that can be of help:

1. Take a Probiotic Supplement

Probiotics can play an important role in helping to boost the body’s natural defenses against bad bacteria. While eating certain foods (such as fermented products like yogurt and kimchi) can certainly help to boost levels of good bacteria in the gut, taking a probiotic supplement regularly prior to getting pregnant can help dramatically increase levels of beneficial bacteria, thus helping to support the microbiota as it undergoes changes during pregnancy.

2. Avoid Antibiotics if Possible

Antibiotics have certainly impacted modern medicine but with their benefits have come a number of problems. For example, antibiotic resistance has led to the emergence of “superbugs” like MRSA that can be fatal. While often necessary, antibiotic use is known to disrupt important microflora by killing off not just the bad bacteria, but a large amount of beneficial good bacteria as well. If you’re planning to get pregnant, avoiding antibiotic use unless absolutely necessary can help to maintain balance in the gut microbiome. Always discuss with your doctor to decide upon the best course of action.

3. Don’t Have a C-Section if Avoidable

Just as with antibiotic use, there will be circumstances in which C-section birth is a necessity. That said, babies who are born vaginally receive significantly higher exposure to beneficial microbes that differ from those typically found on the skin or in breast milk. Since a more diverse microbiota is preferred for newborns, C-section should only be performed when vaginal birth is not an option (though skin-to-skin contact and breastfeeding can help to improve the child’s microbiota for mothers who give birth via C-section).

4. Stay Clear of Hand Sanitizers

Many people are under the impression that hand sanitizer is a crucial defense against harmful pathogens that can lead to colds, bacterial infections and the flu. While practicing proper hand-washing hygiene is always a good idea, hand sanitizers can actually cause more harm to a healthy microbiota than good. These products, along with many cleaning products often contain endocrine disruptors that are capable of affecting sex hormones in infants and newborns, too—just one more reason to steer clear of them.

5. Pay Attention to the Food You Eat

While changes in gut flora are to be expected for women who are pregnant (especially during the third trimester), the food you eat can either slow this process down or speed it up rapidly. Stick to healthy fats, which help fuel the brain, and consider adding fermented foods like sauerkraut to your diet, where beneficial bacteria can be found in concentrated amounts. It may not be enough on its own to keep your gut flora in balance, but it can certainly help.

Probiotics for a Healthy Pregnancy

For women who wish to enjoy a healthy pregnancy and help return gut flora back to normal after giving birth, probiotics can be a highly effective tool to use. Combined with a healthy diet and a mindful approach to the pregnancy, probiotics can help put your mind at ease about dealing with significant changes in the gut microbiome.

Below are three key ways that probiotics can help support a healthy pregnancy.

Strengthened Immune System

Getting sick while pregnant can be a very uncomfortable -- and frightening -- experience, and it’s not uncommon. The immune system naturally operates at less than peak performance throughout pregnancy, and the more you can do to support it, the better you’re likely to feel. Probiotics are known to help support healthy immunity, so taking them before and during pregnancy should help mothers-to-be remain healthy.

Blood Sugar Regulation

In some women, pregnancy can wreak havoc on blood sugar levels. Probiotics can help to optimize blood glucose levels, which may assist in reducing the severity of mood instability. Most important, stable blood sugar levels will simply help you feel better overall throughout the day, especially when it comes to food cravings.

Microflora Boost

A newborn’s microbiota is “seeded” with the mother’s microflora, which is why it’s so important to focus on maintaining balance throughout pregnancy. As getting closer to and in the third trimester can result in a shift toward more “bad” bacteria, support from probiotics can be particularly helpful during the final months of pregnancy.

As research continues, more details about how gut flora and pregnancy are intertwined will likely come to light. For now, however, it’s clear that the connection exists and warrants attention for mothers to be. There are many probiotics available, and pregnant women may want to take something convenient, such as a microshot. Being mindful of increasing the colonies of good microflora will increase chances for a healthy pregnancy – and a healthy baby.
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