Probiotic Safety in Pregnancy: A Systematic Review and Meta-analysis of Randomized Controlled Trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp.

Dugoua, Jean-Jacques; Machado, Márcio; Zhu, Xu; Chen, Xin; Koren, Gideon; Einarson, Thomas R.

doi:10.1016/s1701-2163(16)34218-9

Cited by 99 publications

(67 citation statements)

References 35 publications

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“…However, we are not aware of any previous reports of similar illnesses attributed to ingestion of lactobacilli or bifidobacteria. In keeping with the findings in this study, many studies of probiotics administered during pregnancy have not identified adverse outcomes and a recent systematic review reported no adverse effects of lactobacilli and bifidobacteria during pregnancy (10). In infants, lower respiratory tract infections were reported more frequently in the treatment than the placebo group.…”

Section: Discussionsupporting

confidence: 88%

Dietary Supplementation with Lactobacilli and Bifidobacteria Is Well Tolerated and Not Associated with Adverse Events during Late Pregnancy and Early Infancy

Allen

Jordan

Storey

et al. 2010

The Journal of Nutrition

100

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Lactic acid bacteria and bifidobacteria are increasingly being administered to pregnant women and infants with the intention of improving health. Although these organisms have a long record of safe use, it is important to identify any adverse effects in potentially vulnerable populations. In a randomized, double-blinded, placebo-controlled trial, we evaluated the safety of a bacterial dietary supplement for the prevention of atopy in infants. Two strains of lactobacilli (Lactobacillus salivarius CUL61 and Lactobacillus paracasei CUL08) and bifidobacteria (Bifidobacterium animalis subsp. lactis CUL34 and Bifidobacterium bifidum CUL20) with a total of 1 x 10(10) colony-forming units were administered daily to women during the last month of pregnancy and to infants aged 0-6 mo. Adverse events (AE) were classified according to WHO International Statistical Classification of Diseases criteria. Common symptoms were recorded by regular questionnaires. Baseline characteristics of 220 mother-infant dyads in the treatment and 234 in the placebo group were similar. Compliance with the trial interventions, loss to follow-up, symptoms, drug usage, infant growth, method of feeding, visits to the doctor, and mothers' assessment of infant health were similar in the 2 groups. Fifteen (6.8%) mothers and 73 (33.2%) infants in the treatment group and 21 (9.0%) mothers and 75 (32.1%) infants in the placebo group reported AE (P = 0.49 and P = 0.84, respectively). Severe AE occurred in 18 mothers and 63 infants with a similar frequency in each group. None of the AE were attributed to the intervention. Our findings support the safe use of this consortium of organisms during pregnancy and early infancy.

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Section: Discussionsupporting

confidence: 88%

Dietary Supplementation with Lactobacilli and Bifidobacteria Is Well Tolerated and Not Associated with Adverse Events during Late Pregnancy and Early Infancy

Allen

Jordan

Storey

et al. 2010

The Journal of Nutrition

100

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“…The studies included in the meta-analysis did not report any short-term adverse effect of probiotic supplementation, and several studies (54) confirmed the safety of probiotics use during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis

Zuccotti

Meneghin

Aceti

et al. 2015

Allergy

230

173

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Growing evidence underlines the pivotal role of infant gut colonization in the development of the immune system. The possibility to modify gut colonization through probiotic supplementation in childhood might prevent atopic diseases. The aim of the present systematic review and meta-analysis was to evaluate the effect of probiotic supplementation during pregnancy and early infancy in preventing atopic diseases. PubMed, Embase and Cochrane Library were searched for randomized controlled trials evaluating the use of probiotics during pregnancy or early infancy for prevention of allergic diseases. Fixed-effect models were used, and random-effects models where significant heterogeneity was present. Results were expressed as risk ratio (RR) with 95% confidence interval (CI). Seventeen studies, reporting data from 4755 children (2381 in the probiotic group and 2374 in the control group), were included in the meta-analysis. Infants treated with probiotics had a significantly lower RR for eczema compared to controls

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“…Meta-analysis for use of probiotics during pregnancy is safe except the safety of saccharomyces sepsis whose safety is unknown. 13 Amniotic fluid leakage in twin A sac was continued throughout her conservative management & did not reaccumilated. In our case as there was no evidence of intrauterine infection hence administration of steroid is beneficially.…”

Section: Discussionmentioning

confidence: 96%

Prolonged latency period of 70 days in a diamniotic and dichorionic twin pregnancy complicated by early second trimester rupture of membrane in one sac and its outcome

2015

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A patient with diamniotic dichorionic twin (DADC) pregnancy was on regular antenatal checkup from conception, admitted to emergency department at 21 weeks with leaking PV. On per speculum and pervaginal examination it was found that clear liquor was draining from os & cervix was long and os was closed. USG revealed twin A sac having live fetus of 20 weeks with no liquor and twin B sac having live fetus with plenty of liquor. Considering the emotional aspect of parents we decided for conservative management which includes combination of antibiotics, micronized progesterone as tocolytic, probiotics, L- arginine and absolute bed rest. Caesarean section was performed at 31 weeks as she entered in labour and had cord prolapse. She delivered two live twin babies after a long latency period of 70 days. Twin ‘A’ baby could not be saved because of lung hypoplasia due to prolonged Oligohydraminous but twin ‘B’ was discharged safely along with mother. Since last decade assisted reproduction technique has increased in numbers of twin pregnancies and its complications. The most important are preterm labour and PPROM. On literature review there is no clear cut guide line for management of PPROM in early second trimester in twin pregnancies. This case is reported because of its long latency period of 70 days from PPROM in early 2<sup>nd</sup> trimester in a twin pregnancy to delivery by conservative management and can save the baby in intact sac. Also we can add our experience to currently available limited literature regarding management of such patient.

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Probiotic Safety in Pregnancy: A Systematic Review and Meta-analysis of Randomized Controlled Trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp.

Cited by 99 publications

References 35 publications

Dietary Supplementation with Lactobacilli and Bifidobacteria Is Well Tolerated and Not Associated with Adverse Events during Late Pregnancy and Early Infancy

Dietary Supplementation with Lactobacilli and Bifidobacteria Is Well Tolerated and Not Associated with Adverse Events during Late Pregnancy and Early Infancy

Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis

Prolonged latency period of 70 days in a diamniotic and dichorionic twin pregnancy complicated by early second trimester rupture of membrane in one sac and its outcome

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