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Probiotics for preventing gestational diabetes
Open accessAbstract
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes for mother and infant. The prevention of GDM using lifestyle interventions has proven difficult. The gut microbiome (the composite of bacteria present in the intestines) influences host inflammatory pathways, glucose and lipid metabolism and, in other settings, alteration of the gut microbiome has been shown to impact on these host responses. Probiotics are one way of altering the gut microbiome but little is known about their use in influencing the metabolic environment of pregnancy. OBJECTIVES: To assess the effects of probiotic supplementation when compared with other methods for the prevention of GDM. SEARCH METHODS: We searched the Cochrane Pregnancy and childbirth Group's Trials Register (31 August 2013) and reference lists of the articles of retrieved studies. SELECTION CRITERIA: Randomised and cluster-randomised trials comparing the use of probiotic supplementation with other methods for the prevention of the development of GDM. Cluster-randomised trials were eligible for inclusion but none were identified. Quasi-randomised and cross-over design studies are not eligible for inclusion in this review. Studies presented only as abstracts with no subsequent full report of study results would also have been excluded. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study eligibility, extracted data and assessed risk of bias of included study. Data were checked for accuracy. MAIN RESULTS: Eleven reports (relating to five possible trials) were found. We included one study (six trial reports) involving 256 women. Four other studies are ongoing.The included trial consisted of three treatment arms: probiotic with dietary intervention, placebo and dietary intervention, and dietary intervention alone; it was at a low risk of bias. The study reported primary outcomes of a reduction in the rate of gestational diabetes mellitus (risk ratio (RR) 0.38, 95% confidence interval (CI) 0.20 to 0.70), with no statistical difference in the rates of miscarriage/intrauterine fetal death (IUFD)/stillbirth/neonatal death (RR 2.00, 95% CI 0.35 to 11.35). Secondary outcomes reported were a reduction in infant birthweight (mean difference (MD) -127.71 g, 95% CI -251.37 to -4.06) in the probiotic group and no clear evidence of increased risk of preterm delivery (RR 3.27, 95% CI 0.44 to 24.43), or caesarean section rate (RR 1.23, 95% CI 0.65 to 2.32). The primary infant outcomes of rates of macrosomia and large-for-gestational age infants were not reported. The following secondary outcomes were not reported: maternal gestational weight gain, pre-eclampsia, and the long-term diagnosis of diabetes mellitus; infant body composition, shoulder dystocia, admission to neonatal intensive care, jaundice, hypoglycaemia and long-term rates of obesity and diabetes mellitus. AUTHORS' CONCLUSIONS: One trial has shown a reduction in the rate of GDM when women are randomised to probiotics early in pregnancy but more uncertain evidence of any effect on miscarriage/IUFD/stillbirth/neonatal death. There are no data on macrosomia. At this time, there are insufficient studies to perform a quantitative meta-analysis. Further results are awaited from four ongoing studies.
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Selmi, C. F., Santis, M. D., Laghi, L., & Generali, E. (2015) · Springer eBooks · doi:10.1007/978-3-319-16853-1_8 · Cited by 1
Takahashi, J., & Rindfleisch, J. A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-35868-2.00105-5 · Cited by 2
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Role of Probiotics in Diabetes Mellitus
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Yang, P., Li, Z., Deng, T. K., Lu, T., Chen, Y., He, Z., Zhou, J., & Xiao, X. (2021) · Research Square · doi:10.21203/rs.3.rs-418396/v1 · Cited by 1
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Ong, M. J. (2016) · UWA Profiles and Research Repository (UWA)
ПРОБІОТИКИ З ПОЗИЦІЇ ДОКАЗОВОЇ МЕДИЦИНИ
Chukhray, I. (2019) · Фармацевтичний часопис · doi:10.11603/2312-0967.2019.3.10391
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Carfagnini, C. L. (2023) · Medical Student Research Journal · doi:10.15404/msrj/03.2023.236
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Metadata
- Authors
- Barrett, H. L., Dekker Nitert, M., Conwell, L. S., & Callaway, L. K.
- Affiliations
- The University of Queensland (AU)
- The University of Queensland; School of Medicine; Herston Australia 4029
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2014-02-27
- Volume
- 4
- Issue
- 2
- Pages
- CD009951-CD009951
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6885033
- OpenAlex
- W2159921493
- Cited by
- 101
- References
- 79
- Citations by year
- 2025: 2 · 2024: 14 · 2023: 14 · 2022: 16 · 2021: 8 · 2020: 6 · 2019: 12 · 2018: 9 · 2017: 6 · 2016: 7 · 2015: 6 · 2014: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Update notices
- new_version (2021-04-19)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- probiotics, gestational diabetes mellitus, gestational diabetes prevention, gut microbiota, dietary intervention, birth weight, preterm birth, cesarean section, miscarriage, stillbirth, neonatal death, pregnancy outcomes, risk of bias assessment, meta-analysis of trials, risk of bias
- MeSH terms
- Female, Humans, Pregnancy, Randomized Controlled Trials as Topic, Diabetes, Gestational, Probiotics
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