Small Intestinal Microbiota of Low Body Mass Index (BMI) & Normal BMI Women of Reproductive Age and Microbiota-directed Balanced Energy Protein (MD-BEP) Supplementation in Maternal Environmental Enteric Dysfunction (EED)
Undernutrition among women of reproductive age is more common in South Asia than in any other region. In South Asia, the prevalence of maternal undernutrition varies between 10 and 40%. There is a scarcity of data on the contribution of small intestinal (SI) microbiota to pathogenesis of Environmental Enteric Dysfunction (EED) of malnutrition, as it is difficult to obtain gut biopsy specimens from malnourished individuals, especially children. The Bangladesh Environmental Enteric Dysfunction (BEED) study, involving participants who live in an urban slum (Mirpur) in Dhaka, provided an opportunity to examine the role of the duodenal microbiota in the pathogenesis of EED in children and also performed esophagogastroduodenoscopy (EGD) on thirty-eight 18-45-year-old malnourished (BMI\<18.5 kg/m2) women residing in the same resource-poor setting of Mirpur, Dhaka who failed to respond to an egg/milk/micronutrients- based nutritional intervention comparable to that given to children. In this intervention component, beginning at the end of the first trimester, low-BMI (\<18.5 kg/m2) pregnant women (aged 18-35 years) will be randomly assigned to receive either Microbiota-directed Balanced Energy Protein (MD-BEP) or Ready-to-Use-Supplementary Food Balanced Energy Protein (RUSF-BEP) for the duration of their pregnancy and during the first 3 postnatal months, in addition to standard antenatal care. A parallel cohort of age-matched normal-BMI pregnant women who will not receive any nutritional intervention will serve as a reference control group.
• Bangladeshi female, age 18-35 years
• BMI 20-24.9 kg/m2
• Middle-upper socioeconomic class (≥ $11/day family income)
• Functional dyspepsia
• Willing to sign the consent form
• Willing to provide biological samples during the study period of 6 months
• BMI \<18.5 kg/m2
• No antibiotics for 1 month
• Willing to sign the consent form
• Willing to undergo endoscopy and biopsy
• Willing to provide biological samples during the study period of 6 months
• Willing to receive food supplementation for 3 months
• Bangladeshi female, age 18-35 years
• BMI 20-24.9 kg/m2
• Middle-upper socioeconomic class (≥ $11/day family income)
• Functional dyspepsia
• Willing to sign the consent form
• Willing to provide biological samples during the study period of 6 months
• Bangladeshi female, age 18-35 years
• BMI 20-24.9 kg/m2
• Middle-upper socio-economic class (≥ $11/day family income)
• Enrolled at the end of first-trimester of pregnancy (before 14 weeks of gestation)
• Willing to sign the consent form
• Willing to undergo endoscopy and biopsy
• Willing to provide biological samples during the study period
• Willing to let anthropometry and biological sample collection from her newborn for the first 6 months of life