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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Diabetes

Poster Session 1

(352) Maternal Microbial Metabolite Profiles and Risk of Adverse Pregnancy Outcomes

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  
Objective:
To evaluate the association between cardiometabolic-related gut microbial metabolites and the pregnancy-specific cardiovascular risk factors, small for gestational age (SGA), preterm birth (PTB), and gestational diabetes mellitus (GDM).

Study Design:
Prospective cohort study enrolling patients ≥ 18 years with singleton pregnancy between 10-14 weeks’ gestation. Maternal blood and urine were collected at 10-14 weeks (visit 1), 24-28 weeks (visit 2), and at time of delivery (visit 3). Clinical variables including demographics, medical/obstetric history, pregnancy outcomes, and cardiovascular parameters including blood pressure and baseline labs were collected. Assays for gut microbiota-derived metabolites, trimethylamine-N-oxide (TMAO), phenylacetylglutamine (PAG), indole acetic acid (IAA), and indole-3-propionic acid (I3PA), were performed using isotope dilution LC-MS/MS methods. Metabolite levels were compared between individuals who developed SGA, PTB, and GDM, and those who did not across gestation, and measures of associations were assessed using multivariable logistic regression and reported as crude and adjusted OR(95%CI) after adjusting for potential confounders.

Results:
Visit 1 I3PA levels were significant associated with development of GDM, unadjusted and adjusted OR with 95% CI: 0.19 (0.05,0.71) and 0.17 (0.05,0.66). Visit 3 I3PA showed lower levels associated with GDM but this was no longer significant after adjusting for potential confounders. There was no association with TMAO, PAG, IAA, or I3PA with SGA or PTB.

Conclusion:
Reduced first-trimester levels of I3PA were independently associated with GDM, suggesting early disruption in gut microbe–host metabolic signaling may contribute to dysglycemia. This is consistent with prior evidence linking higher I3PA levels to enhanced insulin sensitivity and a reduced risk of glucose intolerance. No significant associations were observed between gut microbial metabolites and SGA or PTB.