Impact of maternal probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study

Abstract

The perinatal nutritional environment impacts upon the health and well-being of mother and child also in the long term. The aim of the present study was to determine the safety and efficacy of perinatal probiotic-supplemented dietary counselling by evaluating pregnancy outcome and fetal and infant growth during the 24 months' follow-up. Altogether, 256 women were randomised at their first trimester of pregnancy into a control and a dietary intervention group. The intervention group received intensive dietary counselling provided by a nutritionist and were further randomised, double-blind to receive probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12; diet/probiotics) or placebo (diet/placebo). Firstly, probiotic intervention reduced the frequency of gestational diabetes mellitus (GDM); 13 % (diet/probiotics) v. 36 % (diet/placebo) and 34 % (control); P¼ 0·003. Secondly, the safety of this approach was attested by normal duration of pregnancies with no adverse events in mothers or children. No significant differences in prenatal or postnatal growth rates among the study groups were detected. Thirdly, distinctive effects of the two interventions were detected; probiotic intervention reduced the risk of GDM and dietary intervention diminished the risk of larger birth size in affected cases; P¼0·035 for birth weight and P¼ 0·028 for birth length. The results of the present study show that probiotic-supplemented perinatal dietary counselling could be a safe and cost-effective tool in addressing the metabolic epidemic. In view of the fact that birth size is a risk marker for later obesity, the present results are of significance for public health in demonstrating that this risk is modifiable.

The gut microbiota and inflammatory noncommunicable diseases: Associations and potentials for gut microbiota therapies

“…Some probiotics have been demonstrated to exert beneficial metabolic effects in experimental models 83 and in human intervention studies [84][85][86][87] . There is also growing appreciation that probiotics may have a role in gut-brain function and CNSrelated conditions, (as reviewed by) 88 .…”

“…In overweight adults, treatment with galactooligosaccharides induced "favorable" changes in gut microbial composition, increased secretory IgA (sIgA), reduced inflammation and measures of the metabolic syndrome 92 . Notably, the combination of a healthy dietary intervention (increased fiber/reduced fat) and probiotics in pregnancy decreased the risk of gestational diabetes compared with the healthy dietary intervention alone or no intervention 87 . Either alone, or in combination, dietary approaches may be a useful tool for gut microbiota modulation in both the treatment and prevention of NCDs.…”

Gut microbiota: a source of novel tools to reduce the risk of human disease?

“…Interestingly, nutrition counseling and probiotic intervention have been shown to have a different effect on mothers suffering gestational diabetes (GD), whereby probiotics reduce the risk of the disorder while dietary counseling reduces the risk of fetal macrosomia and overgrowth as GD consequence (73). A recent meta-analysis showed a significant reduction in the prevalence and incidence of atopic eczema in children aged 2-7 y whose mothers received probiotics during pregnancy (74).…”

Gut Microbiota and the Pathogenesis of Insulin Resistance

“…Other studies also confirmed that the number of bifidobacteria is lower in obese than in lean individuals [41]. The composition of the gut microbiota in maternal colostrum, or in measured babies, suggest bifidobacteria count might be considered as an index of maintenance of healthy body weight [42••], [43]. Recent reports suggest that the level of bifidobacteria is dependent on the dietary intake because weight loss after bariatric surgery is associated with reduced Bifidobacterium [44••],whereas decreased Bifidobacterium bifidum and Bifidobacterium breve counts and increased Bifidobacterium catenulatum are observed upon weight loss upon dietary intervention in adolescents [45].…”