Inclusion Criteria:
* \> 18 years of age
* Singleton pregnancies
* Recruit during the first trimester and up to 22 weeks of pregnancy.
* Healthy subjects willing and able to provide blood, stool, vaginal swab, and breast milk samples.
* Must be able to provide signed and dated informed consent.
Exclusion Criteria:
* Pre-pregnancy BMI greater than 40
* Blood pressure SBP: \> 160 mmHg -OR- DBP: \> 90 mmHg
* Kidney disease
* Liver disease
* Anemia
* Symptomatic gallstones
* History of bariatric surgery
* Acute disease at time of enrollment (i.e. flu or gastroenteritis). May delay sampling until subject recovers.
* Chronic, clinically significant, unstable (unresolved, requiring on-going changes to medical management or medication) pulmonary, cardiovascular, gastrointestinal, hepatic or renal functional abnormality, as determined by medical history
* History of active uncontrolled gastrointestinal disorders or diseases including:
* Inflammatory bowel disease (IBD) including ulcerative colitis (mild-moderate-severe), Crohn's disease (mild-moderate-severe), or indeterminate colitis;
* Irritable bowel syndrome (IBS) (moderate-severe);
* Persistent, infectious gastroenteritis, colitis or gastritis, persistent or chronic diarrhea of unknown etiology, Clostridium difficile infection (recurrent) or Helicobacter pylori infection (untreated)
* Any confirmed or suspected condition/state of immunosuppression or immunodeficiency (primary or acquired) including HIV infection.
* Surgery of the GI tract, with the exception of cholecystectomy and appendectomy, in the past five years. Any major bowel resection at any time.
* Confirmed or suspected autoimmune disease
Medications:
* Weight loss medications
* Regular high dose aspirin
* Regular use of prescription opiate pain medication
If taken in the past 2 months:
* Systemic antibiotics, antifungals, antivirals or antiparasitics (intravenous, intramuscular or oral)
* Corticosteroids (intravenous, intramuscular, oral, nasal or inhaled)
* Cytokines
* Methotrexate or immunosuppressive cytotoxic agents
Diet \& Lifestyle:
* Recent history of chronic excessive alcohol consumption defined as more than five 1.5-ounce servings of 80 proof distilled spirits, five 12-ounce servings of beer or five 5-ounce servings of wine per day; or \> 14 drinks/week.
* Regular/frequent use of smoking or chewing tobacco, e-cigarettes, cigars or other nicotine-containing products
Maternal chronic medical conditions:
* Pre-gestational diabetes (T1 or T2)
* History of gestational diabetes
* On medication that is an immune modulators or chronic steroid use
* Hyperemesis gravidarum
Pregnancy history:
* Preterm birth
* Recurrent pregnancy loss
