Maternal Probiotic Intervention to Improve Gut Health-Trial II-Pakistan

Inclusion criteria * Women aged 18 years or older in their first or early second trimester of pregnancy (13-17 weeks of gestational age \[GA\]), living in defined geographical areas of Bangladesh (Matlab), Pakistan, Zambia, and Burkina Faso, where it can be assumed that environmental enteropathy is prevalent * Presence of any 2 out of 11 selected bacterial pathogen targets (Aeromonas, Campylobacter coli, Campylobacter jejuni, Campylobacter Pan, Enteroaggregative Escherichia coli, Enteropathogenic Escherichia coli, Enterotoxigenic Escherichia coli, Plesiomonas, Shigella\_EIEC, Salmonella and Klebsiella pneumoniae in fecal samples measured by TAC-qPCR. * Presence of any of the following WASH conditions - 1. use surface water, unimproved water, or limited water for drinking; OR 2. use surface water, unimproved water, or limited water for cooking; OR 3. use surface water, unimproved water, or limited water for washing utensils; OR 4. practice open defecation, use unimproved sanitation (toilet facility), or limited sanitation (toilet facility); OR 5. lack facility or have limited facility for handwashing Exclusion criteria Potential participants will not be enrolled if they: * have MUAC ≥30 cm * are carrying more than one fetus (i.e., multiple pregnancy) * have diarrhea, defined as the passage of three or more loose stools per 24 hours, or have had diarrhea in the preceding 14 days * have fever or an active infection * have taken antibiotics or probiotics in the preceding 14 days * have taken steroids or non-steroidal anti-inflammatory drugs in the preceding 14 days * have severe anemia as determined using finger stick Hb \< 8 g/dl * have a history of chronic digestive disease * have any gastrointestinal contraindication to ingestion of a capsule (known or suspected gastrointestinal obstruction, stricture, fistula, gastroparesis, or any swallowing disorder) * have known immunocompromised status (known history of HIV infection, autoimmune disease, diabetes mellitus, etc.) * have known drug hypersensitivity/allergy/intolerance * have chronic disease or any other illness or condition which in the opinion of the investigator will complicate the assessment of safety or efficacy * are medically disqualified: Any potential participant who is deemed medically unfit for trial enrollment by a non-study healthcare provider, due to the presence of severe or unstable health conditions that could compromise safety or interfere with the study outcomes, will be excluded from participation * have a plan to observe fast any time during the intervention period * have a plan to leave the study area within the follow-up period * are participating in any other interventional trial * belong to a household from which another woman is already enrolled in the study * but may be enrolled if/when these disqualifiers have expired.