Role of prenatal microbiota in fetal programming

Abstract

According to the concept of D. Barker, the intrauterine period is decisive in the programming of postnatal pathology, which can manifest during life. Among the factors of fetal programming, the microbiota plays an important role, but many aspects are still debatable.Objective: analysis and generalization of literary data devoted to the study of the association between the human body and microorganisms, their characteristics during pregnancy and their role in the health and pathology.According to the literature analysis, the article provides data on the non-sterility of the intrauterine environment and ways of its formation. The dynamics and features of “healthy” biotopes of intestines, vagina, mouth and placenta during pregnancy are considered. The main ways of fetus colonization by microorganisms are described, in particular, a major role is given to oral microflora. The effects of prenatal microbiota in physiological and complicated pregnancy, namely in preeclampsia, gestational diabetes, and miscarriage are discussed.Evidence is provided that microbial metabolites are capable of epigenomic modifications that alter fetal metabolism. This is further realized in the diseases of civilization. In addition, there are 360 times more bacterial genes than human genes. Therefore, they are called the “second genome” of a human, which can be changed according to needs. Modern research points to the essential importance of the maternal environment impact on the formation of microflora in fetus and pathology programming, and this process begins in utero. Maternal microbiota in normal and pathological conditions has a direct and indirect effect on the fetus through the immune reactions of the body or microbial metabolites penetrating through the placenta.Conclusions. The importance of microbiota in the metabolic processes of the fetus and newborn is extremely important. Microbiota also plays a significant role in the main pathophysiological aspects of programmed pathology. The development of correct preventive and therapeutic measures to modify the “healthy” microbiota during periods of its active formation should be a perspective for further research. This will allow it to be corrected taking into account the characteristics of individual biotopes.