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Original Research | Obstetrics and Gynecology | Volume 15 Issue 5, May 2026 | Pages: 381 - 386 | India
Impact of Maternal Microbiome Diversity in Early Pregnancy on the Incidence of Hypertensive Disorders in the Third Trimester: A Prospective Cohort Study
Abstract: Introduction: Hypertensive disorders of pregnancy (HDP), including gestational hypertension and pre?eclampsia, remain major causes of maternal and perinatal morbidity and mortality worldwide. Emerging evidence suggests that the maternal microbiome may influence maternal immune, metabolic, and vascular adaptations. However, the extent to which early?pregnancy microbiome diversity predicts HDP onset remains poorly characterised. Objective: To evaluate whether maternal gut and vaginal microbiome diversity in early pregnancy is associated with the subsequent development of HDP. Methods: In a prospective cohort of 350 pregnant women recruited at 10?14 weeks? gestation, maternal gut and vaginal microbiota were characterised via 16S?rRNA gene sequencing. Microbiome alpha and beta?diversity metrics and specific taxa abundances were compared between women who developed HDP and those who remained normotensive. Multivariable logistic regression adjusted for maternal age, BMI, parity, and diet was used to assess independent associations. Results: Among the 333 women analyzed, 38 (11.4%) developed HDP. Women who developed HDP had significantly lower gut microbiome alpha?diversity (Shannon index mean 3.8 vs 4.5, p<0.001) and altered community composition (Bray?Curtis PERMANOVA p=0.02). Specific depletion of beneficial genera (e.g., Akkermansia, Bifidobacterium) and enrichment of pro-inflammatory taxa (e.g., Bilophila, Escherichia/Shigella) were observed. After adjustment, each 0.5?unit higher Shannon index was associated with 30% lower odds of HDP (adjusted OR 0.70; 95% CI 0.55?0.90). Vaginal microbiome diversity showed weaker, non-significant associations. Conclusion: Lower maternal gut microbiome diversity and dysbiosis in early pregnancy are independently associated with an increased risk of HDP. These findings support the hypothesis that the maternal gut microbiota may participate in the pathogenesis of HDP and raise the possibility of early?pregnancy microbiome?targeted risk stratification and preventative strategies.
Keywords: microbiome, pregnancy, hypertensive disorders, pre?eclampsia, maternal gut, vaginal microbiota, dysbiosis
How to Cite?: Dr. Ranima Deka, Dr. Shireen Mumtaz Barbhuiya, "Impact of Maternal Microbiome Diversity in Early Pregnancy on the Incidence of Hypertensive Disorders in the Third Trimester: A Prospective Cohort Study", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 381-386, https://www.ijsr.net/getabstract.php?paperid=MR26506155330, DOI: https://dx.dx.doi.org/10.21275/MR26506155330