Preventive effect of probiotics supplementation on occurrence of gestational diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

Pakmehr, Azin; Ejtahed, Hanieh‐Sadat; Shirzad, Nooshin; Hemmatabadi, Mahboobeh; Farhat, Sara; Larijani, Bagher

doi:10.3389/fmed.2022.1031915

Cited by 7 publications

(6 citation statements)

References 55 publications

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“…No effect of probiotics on the development of GDM in higher-risk women was found, consistent with the results of a Cochrane review [ 11 ]. However, in contrast, a recent meta-analysis (n = 10) showed a significant reduction of GDM with probiotic supplementation in the general antenatal population [ 117 ]. Furthermore, metformin was not found to be effective in preventing GDM in higher risk pregnant women.…”

Section: Discussionmentioning

confidence: 96%

Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials

Quotah,

Andreeva,

Nowak

et al. 2024

Diabetol Metab Syndr

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Background Women at risk of gestational diabetes mellitus (GDM) need preventative interventions. Objective To evaluate targeted interventions before and during pregnancy for women identified as being at risk of developing GDM. Methods Systematic review and meta-analysis conducted following PRISMA guidelines. MEDLINE, EMBASE and the Cochrane Library in addition to reference and citation lists were searched to identify eligible randomised controlled trials (RCTs) utilising risk stratification during the preconception period or in the first/early second trimester. Screening and data extraction were carried out by the authors independently. Quality assessment was conducted based on the Cochrane risk-of-bias tool. Random effects meta-analysis and narrative synthesis were performed. Results Eighty-four RCTs were included: two during preconception and 82 in pregnancy, with a pooled sample of 22,568 women. Interventions were behavioural (n = 54), dietary supplementation (n = 19) and pharmacological (n = 11). Predictive factors for risk assessment varied; only one study utilised a validated prediction model. Gestational diabetes was reduced in diet and physical activity interventions (risk difference − 0.03, 95% CI 0.06, − 0.01; I2 58.69%), inositol (risk difference − 0.19, 95% CI 0.33, − 0.06; I2 92.19%), and vitamin D supplements (risk difference − 0.16, 95% CI 0.25, − 0.06; I2 32.27%). Subgroup analysis showed that diet and physical activity interventions were beneficial in women with ≥ 2 GDM risk factors (risk difference − 0.16, 95% CI 0.25, − 0.07; I2 11.23%) while inositol supplementation was effective in women with overweight or obesity (risk difference − 0.17, 95% CI 0.22, − 0.11; I2 0.01%). Effectiveness of all other interventions were not statistically significant. Conclusions This review provides evidence that interventions targeted at women at risk of GDM may be an effective strategy for prevention. Further studies using validated prediction tools or multiple risk factors to target high-risk women for intervention before and during pregnancy are warranted.

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Section: Discussionmentioning

confidence: 96%

Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials

Quotah,

Andreeva,

Nowak

et al. 2024

Diabetol Metab Syndr

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“…Probiotics have a positive effect on preventing pregnancy complications. In GDM, a meta-analysis of 10 randomized control trials with 2921 pregnant women was published to assess the role of probiotics in GDM women ( 234 ). The results showed that probiotics reduced GDM incidence by 33%, and using multiple-strain probiotics had a greater effect on GDM.…”

Section: Potential Therapeutic Strategiesmentioning

confidence: 99%

“…The selection of an appropriate probiotic strain is important, which may impact the therapeutic effects of probiotics ( 234 ). Therefore, deeper investigation, including different strains of probiotics, was required in the future.…”

Section: Potential Therapeutic Strategiesmentioning

confidence: 99%

Maternal gut microbiota in the health of mothers and offspring: from the perspective of immunology

Lu,

Shi,

Jiang

et al. 2024

Front. Immunol.

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Due to the physiological alteration during pregnancy, maternal gut microbiota changes following the metabolic processes. Recent studies have revealed that maternal gut microbiota is closely associated with the immune microenvironment in utero during pregnancy and plays a vital role in specific pregnancy complications, including preeclampsia, gestational diabetes, preterm birth and recurrent miscarriages. Some other evidence has also shown that aberrant maternal gut microbiota increases the risk of various diseases in the offspring, such as allergic and neurodevelopmental disorders, through the immune alignment between mother and fetus and the possible intrauterine microbiota. Probiotics and the high-fiber diet are effective inventions to prevent mothers and fetuses from diseases. In this review, we summarize the role of maternal gut microbiota in the development of pregnancy complications and the health condition of future generations from the perspective of immunology, which may provide new therapeutic strategies for the health management of mothers and offspring.

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“…Pakmehr et al (2022) focused on the preventive effects of probiotics on GD occurrence. The study concluded that while probiotics might reduce the incidence of GD, the evidence is not conclusive, and no significant benefits or harms related to probiotic supplements on secondary outcomes were observed [44]. Shahriari et al (2021) investigated the effects of probiotic supplementation from the early second trimester until the 24th week of pregnancy.…”

Section: Use Of Probiotics In Gestational Diabetesmentioning

confidence: 99%

Decoding the Gut Microbiota–Gestational Diabetes Link: Insights from the Last Seven Years

Balleza-Alejandri,

Peña-Durán,

Beltrán-Ramírez

et al. 2024

Microorganisms

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The human microbiome, a complex ecosystem of bacteria, viruses, and protozoans living in symbiosis with the host, plays a crucial role in human health, influencing everything from metabolism to immune function. Dysbiosis, or an imbalance in this ecosystem, has been linked to various health issues, including diabetes and gestational diabetes (GD). In diabetes, dysbiosis affects the function of adipose tissue, leading to the release of adipokines and cytokines, which increase inflammation and insulin resistance. During pregnancy, changes to the microbiome can exacerbate glucose intolerance, a common feature of GD. Over the past years, burgeoning insights into the gut microbiota have unveiled its pivotal role in human health. This article comprehensively reviews literature from the last seven years, highlighting the association between gut microbiota dysbiosis and GD, as well as the metabolism of antidiabetic drugs and the potential influences of diet and probiotics. The underlying pathophysiological mechanisms discussed include the impact of dysbiosis on systemic inflammation and the interplay with genetic and environmental factors. By focusing on recent studies, the importance of considering microbial health in the prevention and treatment of GD is emphasized, providing insights into future research directions and clinical applications to improve maternal–infant health outcomes.

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Preventive effect of probiotics supplementation on occurrence of gestational diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

Cited by 7 publications

References 55 publications

Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials

Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials

Maternal gut microbiota in the health of mothers and offspring: from the perspective of immunology

Decoding the Gut Microbiota–Gestational Diabetes Link: Insights from the Last Seven Years

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