Timing of probiotic milk consumption during pregnancy and effects on the incidence of preeclampsia and preterm delivery: a prospective observational cohort study in Norway

Abstract

ObjectivesTo investigate whether the timing of probiotic milk intake before, during early or late pregnancy influences associations with preeclampsia and preterm delivery.DesignPopulation based prospective cohort study.SettingNorway, between 1999 and 2008.Participants70 149 singleton pregnancies resulting in live-born babies from the Norwegian Mother and Child Cohort Study (no chronic disease, answered questionnaires, no placenta previa/cerclage/serious malformation of fetus, first enrolment pregnancy). Only nulliparous women (n=37 050) were included in the preeclampsia analysis. Both iatrogenic and spontaneous preterm delivery (between gestational weeks 22+0 and 36+6) with spontaneous term controls (between gestational weeks 39+0 and 40+6) were included in the preterm delivery analysis resulting in 34 458 cases.Main outcome measuresAdjusted OR for preeclampsia and preterm delivery according to consumption of probiotic milk at three different time periods (before pregnancy, during early and late pregnancy).ResultsProbiotic milk intake in late pregnancy (but not before or in early pregnancy) was significantly associated with lower preeclampsia risk (adjusted OR: 0.80 (95% CI 0.68 to 0.94) p-value: 0.007). Probiotic intake during early (but not before or during late pregnancy) was significantly associated with lower risk of preterm delivery (adjusted OR: 0.79 (0.64 to 0.97) p-value: 0.03).ConclusionsIn this observational study, we found an association between timing of probiotic milk consumption during pregnancy and the incidence of the adverse pregnancy outcomes preeclampsia and preterm delivery. If future randomised controlled trials could establish a causal association between probiotics consumption and reduced risk of preeclampsia and preterm delivery, recommending probiotics would be a promising public health measure to reduce these adverse pregnancy outcomes.

Maternal probiotic milk intake during pregnancy and breastfeeding complications in the Norwegian Mother and Child Cohort Study

“…Women in the probiotic group had significantly lower incidence of mastitis [9]. Furthermore, this study differs by evaluating dietary intake during the first half of pregnancy even if it is assumed that the reported habitual intake of probiotic milk products in pregnancy is a proxy of the continued habitual intake during breastfeeding [16,34]. In this epidemiologic setting, the outcome variables were based on the women's self-reported data and their own initiative to use health-care services and not on medical records with International Classification of Disease (ICD) codes or examination performed by health-care professionals, which might have introduced bias as described above regarding level of education.…”

“…Although pregnancy is a time when most women think a lot about healthy eating, the major changes occur for intake of alcohol and coffee, while their core diet largely remains unchanged [34]. Maternal probiotic milk intake was also asked for in a less comprehensive way in MoBa Q1 and Q3 regarding the time period from before pregnancy to answering Q3 in pregnancy week 32, showing that most women continued to consume probiotic milk products as before pregnancy [16]. Administration of antibiotics, common as prophylaxis in obstetrics, or as treatment for manifest infection, might have interfered with the probiotic effect; this type of datum is not available in the MoBa data set.…”

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

“…Very recently, in a prospective study, Nordqvist et al [192] evaluated the possible relationship among the probiotic milk consumption and the appearance of PTB and preeclampsia incidences. Maternal inflammatory response is a common background of these two pathologic conditions, and the potential anti-inflammatory effect of probiotics represents the criterion for their selection [193,194].…”

Probiotics for woman’s health focus on urogenital infections and reproductive outcomes

“…2,27 The association between intake of probiotic Lactobacilli and reduction in risk of preterm delivery was established in clinical studies. 28,29 Myhre et al, reported that the intake of probiotics reduced the risk of preterm labor by 18% (OR 0.82; 95% CI 0.681-0.986; p = 0.035). However, the study was based on the use of recall questionnaires and there was a lack of clarity in reporting outcomes.…”

“…The authors found that consumption of probiotic product during early pregnancy reduced the risk of preterm delivery by 21% (OR 0.79; CI 0.64-0.97). 29…”