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
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- 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
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