A Review of Modulation of Gut Microbiota to Mitigate Gestational Diabetes: Implications for Maternal and Child Health

The increasing prevalence of gestational diabetes mellitus (GDM) is a pressing global public health concern. Despite extensive identification of GDM risk factors and the implementation of screening programs, there has been a notable lack of significant reduction in maternal, fetal, and neonatal complications. It is vital to recognize that the health trajectory of future generations begins before birth, during intrauterine life and even before conception. The development of 'diabetogenic' and 'obesogenic' changes in the DNA of offspring can be triggered not only by adverse intrauterine conditions, but also by changes in germ cell DNA at earlier stages. Accumulating evidence suggests that the increasing prevalence and persistent metabolic effects of GDM may be mediated by epigenetic modifications. The composition of the human gut microbiota is emerging as a key determinant of human metabolic processes. Consequently, dysbiosis of the gut microbiota via epigenetic mechanisms may contribute to metabolic complications in both the mother and the developing fetus. Given that diet plays a critical role in maintaining a healthy microbiota profile and that certain epigenetic alterations are reversible, it is pertinent to emphasize that not only the pregnant woman but also both partners attempting conception could influence the future health of the child. The aim of this article is to review the role of gut microbiota modulation in preventing and managing gestational diabetes mellitus and the health benefits for mother and child.