Exercising the Patience Muscle, What it’s Like Working as a Researcher?
Time for an update on how things have gone for our SweMaMi study thus far, plus a look into what it’s like to be a researcher. As I wrote last autumn, our research group studies the relationship between pregnant women’s bacterial flora (with samples from the mouth, gut and vagina) and various pregnancy complications. We sync the data from the analyzed bacterial flora and the questionnaire about the woman’s pregnancy, lifestyle, health, eating habits, stress, bowel function and other things. In addition, we ask the parents to collect a sample from the diaper from the newborn baby and we then follow the child’s health for many years to come.
Today we have recruited about 2,300 pregnant women to the study, but fewer than 2000 have submitted samples. We had hoped to finish the recruitment now this summer, but due to the large drop-out we need to extend the recruitment time until we reach our goal of 2,500 women who have both filled in the surveys and submitted the samples to us. Then we need to wait until all SweMaMi babies are born to get the last samples before we start analyzing. You can see how this takes a lot of patience.
In the meantime, we have begun to analyze the questionnaire responses from the first 2000 pregnant women in the study. We are pleased to see that we have received data from almost all of Sweden, about 60% of the studies participants come from areas outside of Stockholm. In addition, the age distribution seems to be representative of pregnant women in Sweden as well. When it comes to education and work, we mainly reach women with college education and full-time jobs, which unfortunately does not represent all pregnant women in Sweden. This will limit our ability to generalize our findings to the entire population.
So far, about 650 babies have been born by mothers who are part of the study, and for the first 444 participants, we have evaluated the questionnaire responses regarding eating habits as well as the reports of depression after childbirth. There seems to be a link between unhealthy eating habits and the onset of depression, especially when it comes to high consumption of sweetened beverages and low consumption of vegetables. Perhaps not quite unexpected, but an important finding that we will analyze further considering that the connection between the intestinal flora and our mental health is a hot research area. Studies in mice show that intestinal bacteria can affect brain development and animal behavior. But when it comes to people, there are no studies that show the connection between the bacterial flora and our mind. Above all, it is uncertain what is cause and what is effect. The connection may be due to several things, such as the fact that it is common to eat sweets as a form of self comforting, but it could also be that the diet affects mental health via a change in the bacteria. We do not yet know how the bacteria in the mouth, intestine and vagina interact with each other in our bodies, hence why our study is so important.
Our research team tries to collect all the knowledge available on pregnancy and bacterial flora, but at present it cannot make any recommendations on specific pre- or probiotics that could prevent miscarriage, premature birth or depression in expectant mothers. Sometimes it may feel a little frustrating, but the more understanding we get for the complexity of the interaction between our bodies and the trillions of microbes that live in and on us, the harder it will be to make cross-proof statements about which we should add. Unfortunately, many unscientific advice is being disseminated by self-proclaimed media experts. Science as of today can only recommend a Mediterranean style diet and a lifestyle with a lot of physical activity to avoid the bacterial flora adversely affecting pregnancy and fetal development.
So more patience is required, but if every women who is pregnant (earlier than week 19) and finds herself residing in Sweden could imagine participating in the SweMaMi study, then, we can together come a bit further in our understandings. Help us spread the information about the study and base the recommendations given to pregnant women on scientific facts.
Ina Schuppe Koistinen is an Associate Professor at Karolinska Institutet and works at the Center for Translational Microbiome Research to study the role of bacterial flora in inflammatory bowel diseases and women’s health. In addition to her research, she is passionate about yoga and guiding people to a healthier lifestyle. She is also active as an artist with watercolor as a medium. The views in the chronicle are the writer’s own.
Watercolor: Ina Schuppe Koistinen