The impact of gestational diabetes on functional capacity of the infant gut microbiome is modest and transient

Gestational diabetes mellitus (GDM) is a metabolic complication that manifests as hyperglycemia during the later stages of pregnancy. In high resource settings, careful management of GDM limits risk to the pregnancy, and hyperglycemia typically resolves after birth. At the same time, previous studies have revealed that the gut microbiome of infants born to mothers who experienced GDM exhibit reduced diversity and reduction in the abundance of several key taxa, including Lactobacillus. What is not known is what the functional consequences of these changes might be. In this case control study, we applied 16S rRNA sequence surveys and metatranscriptomics to profile the gut microbiome of 30 twelve-month old infants to examine the impact of GDM during pregnancy. Relative to mode of delivery and sex of the infant, maternal GDM status had only a limited impact on the structure and function of the developing microbiome. While GDM samples were associated with a decrease in alpha diversity, we observed no effect on beta diversity and no differentially abundant taxa. Further, while mode of delivery and sex of infant affected the expression of multiple bacterial pathways, most of the impact of GDM status on the function of the infant microbiome appears to be lost by twelve months of age. These data serve to reassure parents and paediatricians that, at least in high resource settings, while mode of delivery appears to impact function and diversity for longer than anticipated, GDM may not have persistent effects on the function nor composition of the infant gut microbiome.