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Biomedicines
Volume 13
Issue 12
10.3390/biomedicines13122941
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Article

Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association?

by
Lejla Pašić
1,
Katja Molan
2,
Draženka Pongrac Barlovič
3,4,
Marjanca Starčič Erjavec
5,6,
Darja Žgur Bertok
7 and
Jerneja Ambrožič Avguštin
7,*
1
Sarajevo Medical School, Sarajevo School of Science and Technology, Hrasnička cesta 3a, 71000 Sarajevo, Bosnia and Herzegovina
2
Faculty of Health Sciences, University of Novo mesto, Na Loko 2, 8000 Novo mesto, Slovenia
3
Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia
4
Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
5
Department of Microbiology, Biotechnical Faculty, University of Ljubljana, Večna pot 111, 1000 Ljubljana, Slovenia
6
Department of Biology, Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, 2000 Maribor, Slovenia
7
Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna pot 111, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(12), 2941; https://doi.org/10.3390/biomedicines13122941 (registering DOI)
Submission received: 2 November 2025 / Revised: 23 November 2025 / Accepted: 26 November 2025 / Published: 29 November 2025
(This article belongs to the Section Endocrinology and Metabolism Research)
Versions Notes

Abstract

Background/Objectives: Gestational diabetes mellitus (GDM) is associated with altered maternal gut microbiota and increased risk of large-for-gestational age (LGA) births. The contribution of gut microbiota to fetal overgrowth in GDM, independent of glycemic control, remains unclear. Methods: In this pilot longitudinal study, the gut microbiota of 18 women with GDM was followed from the second (2T) to the third trimester (3T). Maternal fecal samples were analyzed by 16S rRNA gene sequencing, and associations between microbial profiles and infant birth weight were examined. In addition, these associations were adjusted for pre-pregnancy body mass index (BMI) and gestational weight gain (GWG). Results: Maternal gut microbiota of LGA infants exhibited consistently lower microbial diversity, a reduced Bacillota/Bacteroidota ratio, and enrichment of pro-inflammatory taxa including Prevotella, Sutterella, and Bilophila. Short-chain fatty acids (SCFAs)-producing genera such as Acinetobacter, Odoribacter, Faecalibacterium, and Lachnoclostridium were depleted. Although Bilophila was identified as a third-trimester biomarker with LEfSE approach, its association with LGA disappeared after adjusting for BMI and GWG. Conversely, Nitrospirota, Polaromonas, Acinetobacter, and Aeromonas correlated negatively with LGA even after BMI and GWG adjustment. Conclusions: These findings suggest that specific maternal microbiota signatures, together with pre-pregnancy adiposity, influence fetal overgrowth in GDM and may serve as early biomarkers or targets for preventive interventions.
Keywords: gut microbiota; gestational diabetes; large for gestational age infants; gestational weight gain gut microbiota; gestational diabetes; large for gestational age infants; gestational weight gain

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MDPI and ACS Style

Pašić, L.; Molan, K.; Barlovič, D.P.; Starčič Erjavec, M.; Žgur Bertok, D.; Ambrožič Avguštin, J. Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association? Biomedicines 2025, 13, 2941. https://doi.org/10.3390/biomedicines13122941

AMA Style

Pašić L, Molan K, Barlovič DP, Starčič Erjavec M, Žgur Bertok D, Ambrožič Avguštin J. Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association? Biomedicines. 2025; 13(12):2941. https://doi.org/10.3390/biomedicines13122941

Chicago/Turabian Style

Pašić, Lejla, Katja Molan, Draženka Pongrac Barlovič, Marjanca Starčič Erjavec, Darja Žgur Bertok, and Jerneja Ambrožič Avguštin. 2025. "Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association?" Biomedicines 13, no. 12: 2941. https://doi.org/10.3390/biomedicines13122941

APA Style

Pašić, L., Molan, K., Barlovič, D. P., Starčič Erjavec, M., Žgur Bertok, D., & Ambrožič Avguštin, J. (2025). Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association? Biomedicines, 13(12), 2941. https://doi.org/10.3390/biomedicines13122941

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