Gut. 2023 Dec 12:gutjnl-2023-330002. doi: 10.1136/gutjnl-2023-330002.Online ahead of print.

Lin Zhang ^# 1 2 3, Manasi Agrawal ^# 4 5, Siew C Ng ^1 2 3, Tine Jess ^6 7

Author information

¹Microbiota I-Center (MagIC), Hong Kong SAR, China.

²Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.

³Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.

⁴Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark.

⁵The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York NY, New York, USA.

⁶Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark jess@dcm.aau.dk.

⁷Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark.

^#Contributed equally.

Abstract

The early-life period is one of microbiome establishment and immune maturation. Early-life exposures are increasingly being recognised to play an important role in IBD risk. The composition of functions of the gut microbiome in the prenatal, perinatal, and postnatal period may be crucial towards development of health or disease, including IBD, later in life. We herein present a comprehensive summary of the interplay between early-life factors and microbiome perturbations, and their association with risk of IBD. In addition, we provide an overview of host and external factors in early life that are known to impact gut microbiome maturation and exposures implicated in IBD risk. Considering the emerging concept of IBD prevention, we propose strategies to minimise maternal and offspring exposure to potentially harmful variables and recommend protective measures during pregnancy and the postpartum period. This holistic view of early-life factors and microbiome signatures among mothers and their offspring will help frame our current understanding of their importance towards IBD pathogenesis and frame the roadmap for preventive strategies.