The online version of this article (https://doi.org/10.1186/s12884-017-1629-5) contains supplementary material, which is available to authorized users.
Probiotics 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.
We 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.
We 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.
We 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.
We prospectively published the protocol for this study in the PROSPERO database (CRD42016048129).
Additional file 1: Appendix A. Complete search strategy. Complete search strategy; Search terms used in each of the databases used. (DOC 308 kb)12884_2017_1629_MOESM1_ESM.doc
Additional file 2: Tables S1–S8. Tables with additional information and details. (DOCX 43 kb)12884_2017_1629_MOESM2_ESM.docx
Additional file 3: Figure S1–S3. Additional figures of interest. (DOCX 109 kb)12884_2017_1629_MOESM3_ESM.docx
Additional file 4: Appendix B. Individual study data.docx; Individual study data; Individual study data for all outcomes, comparisons and analyses. (DOCX 1588 kb)12884_2017_1629_MOESM4_ESM.docx
Grand View Research. Probiotics Market Analysis By Application (Probiotic Foods & Beverages (Dairy Products, Non-Dairy Products, Cereals, Baked Food, Fermented Meat Products, Dry Food), Probiotic Dietary Supplements (Food Supplements, Nutritional Supplements, Specialty Nutrients, Infant Formula), Animal Feed Probiotics), By End-Use (Human Probiotics, Animal Probiotics) And Segment Forecast To 2024. [ http://www.grandviewresearch.com/industry-analysis/probiotics-market]. Accessed 22 Feb 2017.
Johnston BC, Supina AL, Vohra S. Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials. Can Med Assoc J. 2006;175:377–83. CrossRef
Louik C, Gardiner P, Kelley K, Mitchell AA. Use of herbal treatments in pregnancy. Am. J. Obstet. Gynecol. 2010;202:439. e431–10. CrossRef
Romero R, Espinoza J, Chaiworapongsa T, Kalache K. Infection and prematurity and the role of preventive strategies. Sem Neonatol. 2002;7(4):259–74. CrossRef
Romero R, Espinoza J, Kusanovic JP, Gotsch F, Hassan S, Erez O, et al. The preterm parturition syndrome. BJOG Int J Obstet Gynaecol. 2006;113:17–42. CrossRef
Romero R, Sirtori M, Oyarzun E, Avila C, Mazor M, Callahan R, et al. Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes. Int. J. Gynaecol. Obstet. 1990;32:187. CrossRef
Othman M, Neilson JP, Alfirevic Z. Probiotics for preventing preterm labour. Cochrane Database Syst Rev. 2007;1:CD005941.
Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401. PubMed
Barrett HL, Dekker Nitert M, Conwell LS, Callaway LK. Probiotics for preventing gestational diabetes. Cochrane Database Syst Rev. 2014;2:CD009951.
Shadid R, Haarman M, Knol J, Theis W, Beermann C, Rjosk-Dendorfer D, et al. Effects of galactooligosaccharide and long-chain fructooligosaccharide supplementation during pregnancy on maternal and neonatal microbiota and immunity—a randomized, double-blind, placebo-controlled study. Am J Clin Nutr. 2007;86:1426–37. PubMed
Higgins J, Green S. Cochrane handbook for systematic reviews of interventions 5.1.0 [updated March 2011]. In .: The Cochrane Collaboration; 2011.
Taghizadeh M, Alizadeh S, Asemi Z. Effect of Daily Consumption of a Synbiotic Food on Pregnancy Outcomes: A Double-Blind Randomized Controlled Clinical Trial, Women Health Bull. 2016;3(1):e27195.
Taghizadeh M, Asemi Z. Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial. Hormones. 2014;13:398–406. PubMed
Kukkonen K, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2007, 119:192–8.
Ho M, Chang YY, Chang WC, Lin HC, Wang MH, Lin WC, et al. Oral lactobacillus rhamnosus GR-1 and lactobacillus reuteri RC-14 to reduce group B streptococcus colonization in pregnant women: a randomized controlled trial. Taiwan. 2016;55:515–8.
Lindsay KL, Brennan L, Kennelly MA, Maguire OC, Smith T, Curran S, et al. Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol. 2015;212:496.e491–11.
Kim JY, Kwon JH, Ahn SH, Lee SI, Han YS, Choi YO, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol. 2010;21:e386–93. CrossRefPubMed
Bergmann RL, Haschke-Becher E, Klassen-Wigger P, Bergmann KE, Richter R, Dudenhausen JW, et al. Supplementation with 200 mg/day docosahexaenoic acid from mid-pregnancy through lactation improves the docosahexaenoic acid status of mothers with a habitually low fish intake and of their infants. Ann Nutr Metab. 2008;52:157–66. CrossRefPubMedPubMedCentral
Karamali M, Dadkhah F, Sadrkhanlou M, Jamilian M, Ahmadi S, Tajabadi-Ebrahimi M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes & metabolism. 2016;42(4):234-41.
Jafarnejad S, Saremi S, Jafarnejad F, Arab A. Effects of a multispecies Probiotic mixture on Glycemic control and inflammatory status in women with gestational diabetes: a randomized controlled clinical trial. J Nutr Metab. 2016;
Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet (London, England). 2001;357:1076–9. CrossRef
Mastromarino P, Capobianco D, Miccheli A, Pratico G, Campagna G, Laforgia N, et al. Administration of a multistrain probiotic product (VSL#3) to women in the perinatal period differentially affects breast milk beneficial microbiota in relation to mode of delivery. Pharmacol Res. 2015;95-96:63–70. CrossRefPubMed
The World Bank. World Bank Country and Lending Groups. [ https://datahelpdesk.worldbank.org/knowledgebase/articles/906519]. Accessed 20 Feb 2017.
Bender R, Friede T, Koch A, Kuss O, Schlattmann P, Schwarzer G et al. Performing meta-analyses in the case of very few studies. In: Cochrane Colloquium. Seoul; 2016.
- Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis
Jennifer C. Stearns
Stephen M. Collins
Sarah D. McDonald
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
e.Med Kampagnen-Visual, Mail Icon II