Environmental enteric dysfunction: gut and microbiota adaptation in pregnancy and infancy

Area of Science:

• Pediatric Nutrition and Development
• Gastroenterology and Gut Microbiome Research
• Global Public Health

Background:

• Environmental enteric dysfunction (EED) is a prevalent subclinical intestinal syndrome characterized by inflammation, malabsorption, and barrier disruption.
• It disproportionately affects children in low- and middle-income countries, linked to poverty, food insecurity, and pathogen exposure.
• EED significantly impairs child growth, immunity, and neurodevelopment.

Purpose of the Study:

• To review current understanding of EED, intestinal adaptation, and the gut microbiome during the critical first 1,000 days of life.
• To highlight emerging data on maternal EED and its association with adverse pregnancy outcomes.
• To emphasize the need for mechanistic insights into how EED disrupts early-life development.

Main Methods:

• This review synthesizes existing research on EED, intestinal adaptation, and the gut microbiome.
• It incorporates data on maternal health, pregnancy outcomes, and early childhood development.
• The review focuses on the period from conception through early childhood (first 1,000 days).

Main Results:

• Pregnancy and lactation impose significant metabolic demands, driving gut adaptation and altering the maternal gut microbiota.
• Maternal EED is associated with increased risks of preterm birth and fetal growth restriction.
• Changes in the gut microbiome composition and function occur during pregnancy and are transmitted from mother to child.

Conclusions:

• Environmental enteric dysfunction poses a significant threat to child development, particularly in resource-limited settings.
• Understanding the interplay between EED, maternal health, and the gut microbiome is crucial for early intervention.
• Further research is needed to elucidate EED mechanisms and develop strategies to break intergenerational cycles of undernutrition.