Maternal use of probiotics during pregnancy and effects on their offspring’s health in an unselected population

Rutten, Nicole B.; Gugten, Anne van der; Uiterwaal, Cuno S.P.M.; Vlieger, Arine M.; Rijkers, Ger T.; Ent, Cornelis K. van der

doi:10.1007/s00431-015-2618-1

Cited by 22 publications

(10 citation statements)

References 33 publications

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“…In particular, women of reproductive age are prone to use these products for gastrointestinal symptoms [10]. Another important catchment area is represented by pregnant women, as it is estimated that up to 1 woman out of 7 in the Netherlands regularly use probiotics during gestation [11].…”

Section: Introductionmentioning

confidence: 99%

Probiotics and vaginal microecology: fact or fancy?

et al. 2019

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BackgroundProbiotics are live microorganisms that, when administered in adequate amounts, should confer a health benefit to the host. Media sources tend to present probiotics as an appealing health promotion method able to prevent or treat a wide variety of clinical conditions. In obstetrics and gynaecology, Lactobacilli species are mainly used to restore the physiologic vaginal microbiota in order to treat bacterial vaginosis and vulvovaginal candidiasis (VVC) and prevent preterm birth.DiscussionSeveral RCTs investigated the potential benefits of probiotics in gynaecological and obstetrics conditions. For all potential indications, recent specific meta-analyses have been published. Considering vulvovaginal candidiasis in non-pregnant women, probiotics slightly improved the short-term clinical and mycological cure, and reduced the 1-month relapse. However, no important impact of probiotic use was observed on long-term clinical or mycological cure. Similarly, the addition of probiotics to metronidazole for the treatment of bacterial vaginosis was not shown to provide any additional benefit. In obstetrics, using probiotics during pregnancy neither decreased nor increased the risk of preterm birth before 34 weeks or before 37 weeks. Similarly, no benefits emerged for gestational diabetes, preterm premature rupture of membrane, and small and large for gestational age infants.ConclusionDespite increasing marketing of probiotics for the treatment of vulvovaginal candidiasis and prevention of preterm birth robust evidence demonstrating a beneficial effect is scarce. Moreover, there was considerable heterogeneity among the different studies in terms of route of administration, strain/s of probiotic adopted, and length of probiotic use. Before recommending the systematic use of probiotics to treat bacterial vaginosis and VVC and prevent preterm birth, high-quality research is needed. Professional medical associations should issue recommendations defining if, when, and how probiotics should be used for gynaecological disorders.

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Section: Introductionmentioning

confidence: 99%

Probiotics and vaginal microecology: fact or fancy?

et al. 2019

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“…Women of childbearing age are one of the commonest groups to take probiotics for gastrointestinal symptoms [ 7 ]. Among pregnant women, 1.3 to 3.6% use probiotics in the United States and Canada, and up to 13.7% do so in the Netherlands [ 8 , 9 ]. It has been speculated that probiotics might help prevent preterm birth [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis

Jarde

Lewis-Mikhael

Martin

et al. 2018

BMC Pregnancy Childbirth

129

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BackgroundProbiotics are living microorganisms that, when administered in adequate amounts, confer a health benefit. It has been speculated that probiotics might help prevent preterm birth, but in two previous systematic reviews possible major increases in this risk have been suggested. Our objective was to perform a systematic review and meta-analysis of the risk of preterm birth and other adverse pregnancy outcomes in pregnant women taking probiotics, prebiotics or synbiotics.MethodsWe searched six electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science’s Core collection and BIOSIS Preview) up to September 2016 and contacted authors for additional data. We included randomized controlled trials in which women with a singleton pregnancy received a probiotic, prebiotic or synbiotic intervention. Two independent reviewers extracted data using a piloted form and assessed the risk of bias using the Cochrane risk of bias tool. We used random-effects meta-analyses to pool the results.ResultsWe identified 2574 publications, screened 1449 non-duplicate titles and abstracts and read 160 full text articles. The 49 publications that met our inclusion criteria represented 27 studies. No study used synbiotics, one used prebiotics and the rest used probiotics. Being randomized to take probiotics during pregnancy neither increased nor decreased the risk of preterm birth < 34 weeks (RR 1.03, 95% CI 0.29–3.64, I2 0%, 1017 women in 5 studies), preterm birth < 37 weeks (RR 1.08, 95% CI 0.71–1.63, I2 0%, 2484 women in 11 studies), or most of our secondary outcomes, including gestational diabetes mellitus.ConclusionsWe found no evidence that taking probiotics or prebiotics during pregnancy either increases or decreases the risk of preterm birth or other infant and maternal adverse pregnancy outcomes.Trial registrationWe prospectively published the protocol for this study in the PROSPERO database (CRD42016048129).Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1629-5) contains supplementary material, which is available to authorized users.

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“…65 Lastly, in a study of 2,491 women, 13.7% of whom used self-prescribed probiotics, no improvement in pregnancy outcomes was found. 66 Interestingly, in light of the mixed data on these probiotic treatment trials, emerging studies in east Africa have suggested that the development and cultivation of locally grown fermented foods and probiotic cultures may be an emerging alternative prophylactic practice aimed at providing protection for illness or toxin exposure and an alternative approach to therapeutic administration of probiotics and/or prebiotics. [67][68][69][70] Necrotizing enterocolitis.…”

Section: Infantile Risk Factors and Diseases Associated With Microbiomentioning

confidence: 99%

The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood

Slattery

MacFabe

Frye

2016

Clin Med Insights Pediatr

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Recent studies have highlighted the fact that the enteric microbiome, the trillions of microbes that inhabit the human digestive tract, has a significant effect on health and disease. Methods for manipulating the enteric microbiome, particularly through probiotics and microbial ecosystem transplantation, have undergone some study in clinical trials. We review some of the evidence for microbiome alteration in relation to childhood disease and discuss the clinical trials that have examined the manipulation of the microbiome in an effort to prevent or treat childhood disease with a primary focus on probiotics, prebiotics, and/or synbiotics (ie, probiotics + prebiotics). Studies show that alterations in the microbiome may be a consequence of events occurring during infancy and/or childhood such as prematurity, C-sections, and nosocomial infections. In addition, certain childhood diseases have been associated with microbiome alterations, namely necrotizing enterocolitis, infantile colic, asthma, atopic disease, gastrointestinal disease, diabetes, malnutrition, mood/anxiety disorders, and autism spectrum disorders. Treatment studies suggest that probiotics are potentially protective against the development of some of these diseases. Timing and duration of treatment, the optimal probiotic strain(s), and factors that may alter the composition and function of the microbiome are still in need of further research. Other treatments such as prebiotics, fecal microbial transplantation, and antibiotics have limited evidence. Future translational work, in vitro models, long-term and follow-up studies, and guidelines for the composition and viability of probiotic and microbial therapies need to be developed. Overall, there is promising evidence that manipulating the microbiome with probiotics early in life can help prevent or reduce the severity of some childhood diseases, but further research is needed to elucidate biological mechanisms and determine optimal treatments.

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Maternal use of probiotics during pregnancy and effects on their offspring’s health in an unselected population

Cited by 22 publications

References 33 publications

Probiotics and vaginal microecology: fact or fancy?

Probiotics and vaginal microecology: fact or fancy?

Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis

The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood

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