Reporting of Perinatal Outcomes in Probiotic Randomized Controlled Trials. A Systematic Review and Meta-Analysis

Abstract

The use of probiotic microorganisms in clinical practice has increased in recent years and a significant number of pregnant women are regular consumers of these products. However, probiotics might modulate the immune system, and whether or not this modulation is beneficial for perinatal outcomes is unclear. We performed a systematic review and meta-analysis to evaluate the reporting of perinatal outcomes in randomized controlled trials including women supplemented with probiotic microorganisms during pregnancy. We also analyzed the effects that the administration of probiotic microorganisms exerts on perinatal outcomes. In the review, 46 papers were included and 25 were meta-analyzed. Reporting of perinatal outcomes was highly inconsistent across the studies. Only birth weight, cesarean section, and weeks of gestation were reported in more than 50% of the studies. Random effects meta-analysis results showed that the administration of probiotic microorganisms during pregnancy did not have any a positive or negative impact on the perinatal outcomes evaluated. Subgroup analysis results at the strain level were not significantly different from main analysis results. The administration of probiotic microorganisms does not appear to influence perinatal outcomes. Nonetheless, future probiotic studies conducted in pregnant women should report probiotic strains and perinatal outcomes in order to shed light upon probiotics’ effects on pregnancy outcomes.

Maternal Intake of Probiotics to Program Offspring Health

“…As shown in Table 2 , supplementation with various probiotic mixes starting at the beginning of pregnancy, at the second trimester, or at the end of pregnancy had no impact on neonatal birth weight, body mass index, birth length, femur length, or head circumference [ 52 , 53 , 54 •, 55 , 56 •]. These findings align with a recent meta-analysis investigating infant birth weight following exposure to Lacticaseibacillus rhamnosus strains alone or in mixtures with Streptococcus or Bifidobacterium strains started during mid- or late-pregnancy [ 57 ]. Sex-specific effects have not been comprehensively studied.…”

Intestinal Dysbiosis in the Infant and the Future of Lacto-Engineering to Shape the Developing Intestinal Microbiome

“…169 Attempts to decrease risk of preterm delivery or increase infant birth weight by altering the maternal vaginal or intestinal microbiota with probiotics have been disappointing to date. 170 In a single small study, maternal consumption of probiotic dietary supplements after birth did not decrease the risk of NEC or mortality in preterm infants 171 , 172 ; however, a meta-analysis of maternal consumption of probiotics during pregnancy and lactation exhibited a significant reduction in atopic dermatitis but not other allergic diseases, 173 presumably by altering the maternal intestinal and milk microbiota. 174 A full review of traditional botanicals and phytochemicals that influence lactation and the infant gut microbiota is beyond the scope of this article and would be a valuable addition to the literature.…”

Drug-Induced Microbiome Changes: Considerations in Pregnancy

“…Within the last several years, various reviews and meta-analysis attempt to summarize the burgeoning body of research evaluating the effect of probiotic supplementation during pregnancy. 3,[31][32][33][34][35][36][37][38][39][40][41] There is consistent evidence that maternally derived probiotic bacteria is transferred to the fetus. How long these supplemented strains persist in the offspring microbiome is less clear.…”