Kara Margolis, MD: Long-Term Impact of Maternal Microbiota on Infant Gut-Brain Health

At the 2024 Annual North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Meeting in Hollywood, Florida, from November 7 to 9, 2024, HCPLive spoke to Kara Margolis, MD, from New York University, about her team’s study discovering the link between maternal SSRI exposure and the increased risk of constipation in infants.

“We saw that up to 15 years of age, which is as long as we measured, that there was an increased risk of being diagnosed with a disorder of gut-brain interaction, and that was largely driven by a diagnosis of chronic constipation,” Margolis said, describing a population-based study with approximately 50,000 kids from Denmark that is still under review. “So, I think there are long-term effects, at least from what our studies show thus far.”

However, at NASPGHAN, Margolis and her team presented a longitudinal birth cohort study that evaluated the association between maternal depression with and without prenatal SSRI exposures and the risk of gut-brain interaction during infancy and early childhood. In total, 317 mother-child dyads were recruited; mothers either had maternal depression and were on SSRIs, had maternal depression and were not on SSRIS, or did not have maternal depression and not on SSRIS. The trial followed dyads from the first trimester of pregnancy to 24 months of age.

The research revealed prenatal SSRI exposure was linked to a significantly increased risk for functional constipation in children, compared with no prenatal SSRI exposure (63% vs 31%; P = .001). Additionally, colic was more prevalent in children aged 1 – 3 months whose mothers took SSRIs for their maternal depression versus mothers who did not (13% vs 1.6%; P = .048).

Even after the study, Margolis said maternal microbiota’s impact on fetal or neonatal gut-brain health is still the golden question that warrants further research. Although it is understood that in vaginal births the maternal microbiota is transferred to the baby Margolis said it needs to be determined whether the maternal microbiome is in the same for the mother and the child, as well as biomarkers for a diagnosis of a gut-brain interaction disorder.

“I think following these kids’ long term and understanding the microbiome as a potential biomarker may not only be able to tell us who develops a disorder of gut-brain interaction, or in this case, specifically functional constipation, but we have biomarkers for those patients that actually ultimately develop mood disorders as well,” Margolis said.

References

^{Bouchard, V, Gillet, V, Hua, J. Maternal Depression +/- In Utero Ssri Exposures Differentially Increase The Diagnostic Risk Of Disorders Of Gut-Brain Interaction (Dgbi): Seminal Data From The Prospective Birth Cohort Study “Development Of Functional Gastrointestinal Disorders (Getgas)”. Presented at NASPHGAN 2024 in Hollywood, Florida, from November 7 – November 9, 2024.}