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Diabetes Care. 2019 Mar;42(3):364-371. doi: 10.2337/dc18-2248. Epub 2019 Jan 18.

Probiotics for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Women: Findings From the SPRING Double-Blind Randomized Controlled Trial.

Author information

1
Women's and Newborn Services, Royal Brisbane and Women's Hospital, Herston, Australia l.callaway@uq.edu.au.
2
Faculty of Medicine, The University of Queensland, Herston, Australia.
3
Mater Medical Research Institute, South Brisbane, Australia.
4
Women's and Newborn Services, Royal Brisbane and Women's Hospital, Herston, Australia.
5
James Cook University, Mackay, Australia.
6
Department of Nutrition and Dietetics, Mater Group, South Brisbane, Australia.
7
Redcliffe Hospital, Redcliffe, Australia.
8
Faculty of Medicine, University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Australia.
9
QIMR Berghofer Medical Research Institute, Herston, Australia.
10
School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Australia.

Abstract

OBJECTIVE:

Given the role of gut microbiota in regulating metabolism, probiotics administered during pregnancy might prevent gestational diabetes mellitus (GDM). This question has not previously been studied in high-risk overweight and obese pregnant women. We aimed to determine whether probiotics (Lactobacillus rhamnosus and Bifidobacterium animalis subspecies lactis) administered from the second trimester in overweight and obese women prevent GDM as assessed by an oral glucose tolerance test (OGTT) at 28 weeks' gestation. Secondary outcomes included maternal and neonatal complications, maternal blood pressure and BMI, and infant body composition.

RESEARCH DESIGN AND METHODS:

This was a double-blind randomized controlled trial of probiotic versus placebo in overweight and obese pregnant women in Brisbane, Australia.

RESULTS:

The study was completed in 411 women. GDM occurred in 12.3% (25 of 204) in the placebo arm and 18.4% (38 of 207) in the probiotics arm (P = 0.10). At OGTT, mean fasting glucose was higher in women randomized to probiotics (79.3 mg/dL) compared with placebo (77.5 mg/dL) (P = 0.049). One- and two-hour glucose measures were similar. Preeclampsia occurred in 9.2% of women randomized to probiotics compared with 4.9% in the placebo arm (P = 0.09). Excessive weight gain occurred in 32.5% of women in the probiotics arm (55 of 169) compared with 46% in the placebo arm (81 of 176) (P = 0.01). Rates of small for gestational age (<10th percentile) were 2.4% in the probiotics arm (5 of 205) and 6.5% in the placebo arm (13 of 199) (P = 0.042). There were no differences in other secondary outcomes.

CONCLUSIONS:

The probiotics used in this study did not prevent GDM in overweight and obese pregnant women.

PMID:
30659070
DOI:
10.2337/dc18-2248

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