The gut-brain axis in the perinatal period: nausea, anxiety and depression

Pregnancy and the perinatal period present metabolic, immune and hormonal challenges to the body. Neurological symptoms are also common in this period, including nausea, the "baby blues" and perinatal depression.

Both nausea and depressive symptoms present on a scale from mild incovenience to severe symptoms putting mother and child at risk.

Some risk factors are well-known; still, these factors do not allow for early identification and support of high risk pregnancies, and more is needed.Here, we use two large cohorts comprising in total 4,551 pregnancies, with questionnaire data, medical records, fecal and saliva samples taken in the first and third trimester and 8 weeks post-partum.

Microbiome species and gene pathway composition will be determined in the stools and saliva of volunteers through shotgun sequencing.

We will characterize how pre-pregnancy factors shape the maternal microbiome and how it progresses over uncomplicated pregnancies.

For nausa, which mostly occurs in the first trimester, we will do a cross-sectional analysis of microbial, dietary and other factors that affect the severity of nausea. Additionally, we will use machine learning approaches to predict cases where nausea persists past pregnancy week 20.

For depression, we will use machine learning both to predict new onset of depressive symptoms postpartum and to separate women with transient depression from those who remain symptomatic 6 months post-partum.