Table_1_Insight Into the Potential Value of Gut Microbial Signatures for Prediction of Gestational Anemia.docx

The gut microbiota alternations are associated with gestational anemia (GA); however, limited predictive value for the subsequent incidence of anemia in normal gestational women has been obtained. We sought to rigorously characterise gut dysbiosis in subjects with GA and explored the potential predictive value of novel microbial signatures for the risk of developing GA. A prospective cohort of subjects with GA (n = 156) and healthy control (n = 402), all of whom were free of GA in the second trimester, by 16S rRNA gene sequencing was conducted. Microbial signatures altered dramatically in GA compared with healthy control in the second trimester. Megamonas, Veillonella, and Haemophilus were confirmed to show differential abundances in GA after adjusting for covariates. On the contrary, Lachnospiraceae and Blautia were enriched in control. Microbial co-abundance group (CAG) network was constructed. Prospectively, CAG network relatively accurately predicted upcoming GA in normal pregnant women with an AUC of 0.7738 (95%CI: 0.7171, 0.8306) and the performance was further validated in Validation set (0.8223, 95%CI: 0.7573, 0.8874). Overall, our study demonstrated that alterations in the gut microbial community were associated with anemia in pregnancy and microbial signatures could accurately predict the subsequent incidence of anemia in normal pregnant women. Our findings provided new insights into understanding the role of gut microbiota in GA, identifying high-risk individuals, and modulating gut microbiota as a therapeutic target, thus improving quality of life and well-being of women and children.