Are Probiotics and Prebiotics Safe for Use during Pregnancy and Lactation? A Systematic Review and Meta-Analysis
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Abstract
Probiotic and prebiotic products have shown potential health benefits, including for the prevention of adverse pregnancy outcomes. The incidence of adverse effects in pregnant people and their infants associated with probiotic/prebiotic/synbiotic intake, however, remains unclear. The objectives of this study were to evaluate the evidence on adverse effects of maternal probiotic, prebiotic, and/or synbiotic supplementation during pregnancy and lactation and interpret the findings to help inform clinical decision-making and care of this population. A systematic review was conducted following PRISMA guidelines. Scientific databases were searched using pre-determined terms, and risk of bias assessments were conducted to determine study quality. Inclusion criteria were English language studies, human studies, access to full-text, and probiotic/prebiotic/synbiotic supplementation to the mother and not the infant. In total, 11/100 eligible studies reported adverse effects and were eligible for inclusion in quantitative analysis, and data were visualised in a GOfER diagram. Probiotic and prebiotic products are safe for use during pregnancy and lactation. One study reported increased risk of vaginal discharge and changes in stool consistency (relative risk [95% CI]: 3.67 [1.04, 13.0]) when administering Lactobacillus rhamnosus and L. reuteri. Adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mother or infant. Our findings and knowledge translation visualisations provide healthcare professionals and consumers with information to make evidence-informed decisions about the use of pre- and probiotics.
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Of 100 eligible studies of probiotic administration during pregnancy, only 28 reported adverse events; of these, only 11 reported adverse events potentially causally related to treatment, including gastrointestinal problems, nausea, and headache, but no serious health concerns were reported for mother or infant.
“Of 100 eligible studies of probiotic administration during pregnancy, only 28 reported AEs. Of these, only 11 reported AEs that potentially could have a causal relationship with the treatment, including gastrointestinal problems, nausea, and headache; but no serious health concerns were reported for mother or infant.117”
From Emerging issues in probiotic safety: 2023 perspectives (2023) · cites this paper as [117]
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References 69 · Cited by 75
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- Authors
- Sheyholislami, H., & Connor, K. L.
- Affiliations
- Carleton University (CA)
- Corresponding author
- Connor, Kristin L.
- ORCID
- Connor, Kristin L.
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-07-13
- Volume
- 13
- Issue
- 7
- Pages
- 2382
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC8308823
- OpenAlex
- W3181277708
- Cited by
- 75
- References
- 69
- Citations by year
- 2026: 16 · 2025: 16 · 2024: 19 · 2023: 12 · 2022: 10 · 2021: 2
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Carleton University's Institutional Repository (MacOdrum Library, Carleton University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- probiotics, prebiotics, synbiotics, pregnancy, lactation, maternal supplementation, adverse effects, safety, Lactobacillus rhamnosus, Lactobacillus reuteri, vaginal discharge, stool consistency, infant health
- MeSH terms
- Female, Humans, Infant, Infant, Newborn, Lactation, Pregnancy, Prenatal Exposure Delayed Effects, Risk Factors, Risk Assessment, Probiotics, Prebiotics, Synbiotics
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