The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

Abstract

AimThe aim of this study was to complete a pilot project to ascertain if the research design was appropriate to determine whether a daily oral dose of probiotics can reduce the rate of vaginal group B streptococcal (GBS) colonisation in pregnancy. MethodologyA pilot randomised controlled trial was performed which recruited 34 GBS-positive women who were approximately 36 weeks pregnant. The participants were randomly allocated to the control group, who continued with standard antenatal care, or to the intervention group, which continued with standard antenatal care and received a daily oral dose of probiotics for three weeks or until the birth of their infant. A lower vaginal swab to detect the presence of GBS was collected three weeks post consent or when a participant was in labour. ResultsNo significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. As a secondary finding of the analysis did show significantly more vaginal commensals in the probiotics group (p=0.048).iii DiscussionThere are five possible reasons for the lack of significant results: The length of the intervention was too short. The dosage of the probiotics was too low. The wrong strains of probiotics were used. The sample size was inadequate. Oral probiotics are ineffective in impacting vaginal GBS. ImplicationsThe secondary finding of a significant increase of vaginal commensals (normal

Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis

“…Despite these promising results, in both cases, no relationship has been found between the dose applied and the obtained respond. Finally, the results from the studies of Haahr et al [195] and Olsen et al [196] do not support the probiotic treatment of BV-positive pregnant women with the objective of (i) diminishing the spontaneous PTB risk and, (ii) reducing the colonization rate of Group B Streptococcal (GBS) on the vagina.…”

Do probiotics in pregnancy reduce the risk of group B streptococcal colonisation?

“…Five did not have outcomes of interest so were excluded: two were in vitro studies, one used historical controls, and one was an animal study. A total of six articles were selected for the review 2–7 . Aziz et al ., Warrack et al .…”

“…Four studies ( n = 402) consisting of three RCTs, 2,4,5 and one quasi‐randomised, open label feasibility study, 3 were included in this review. Full study details were available for all of the studies, except Aziz et al .…”

Group B Streptococcal Bacteriuria in Pregnancy: An Evidence‐Based, Patient‐Centered Approach to Care

“…Presently, no known alternatives, including chlorhexidine vaginal wash, garlic, or probiotics, have sufficient, high-quality research to support their use for reduction of GBS-related neonatal morbidity and mortality. 20,23,24…”