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BMC Pregnancy Childbirth. 2018 Jan 8;18(1):14. doi: 10.1186/s12884-017-1629-5.

Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis.

Author information

1
Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. jarde@mcmaster.ca.
2
Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
3
Department of Medicine, Gastroenterology Division, McMaster University, Hamilton, ON, Canada.
4
Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
5
Farncombe Family Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada.
6
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.

Abstract

BACKGROUND:

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.

METHODS:

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.

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.

CONCLUSIONS:

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.

TRIAL REGISTRATION:

We prospectively published the protocol for this study in the PROSPERO database ( CRD42016048129 ).

KEYWORDS:

Prebiotics; Pregnancy; Preterm birth; Probiotics; Synbiotics

PMID:
29310610
PMCID:
PMC5759212
DOI:
10.1186/s12884-017-1629-5
[Indexed for MEDLINE]
Free PMC Article

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