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Grand Rounds

Could Probiotic Milk Reduce Pregnancy Risks?

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BACKGROUND AND PURPOSE:

  • Probiotics are defined as ‘live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host’
  • Research as demonstrated that oral probiotics may
    • Have anti-inflammatory effects
    • Colonize the vagina and normalize bacterial flora (such as in the treatment of vaginal candidiasis – see ‘Related ObG Topics’ below)
  • There is previous research demonstrating an association with probiotics and reduced risk for preeclampsia and preterm birth
  • Nordqvist et al. (BMJ Open, 2018) determined whether probiotic milk intake during pregnancy is associated with reduced risk for preeclampsia and preterm delivery

METHODS:

  • Population based prospective cohort study
  • Participants: Women with singleton pregnancies, resulting in live-born babies
    • Only nulliparous were included in the preeclampsia evaluation
  • Information was collected form the Norwegian Mother and Child Cohort Study
  • Both iatrogenic and spontaneous preterm delivery (22w0d to 36w6d) with spontaneous term controls (between 39w0d and 40w6d) were included in the preterm delivery analysis
  • Categories that were used to apply the diagnosis of preeclampsia
    • HELLP syndrome
    • Eclampsia
    • Early onset preeclampsia <34 weeks
    • Mild preeclampsia
    • Severe preeclampsia
  • Subjects were categorized according to consumption of probiotic milk at three different time periods
    • Before pregnancy
    • Early pregnancy: Derived from Questionnaire 1 (questions answered on average around week 17)
    • Late Pregnancy: Derived from Questionnaire 3 (questions answered on average around 30 weeks)
  • Primary outcome was adjusted odds ratio (OR) for preeclampsia and preterm delivery according to probiotic milk consumption

RESULTS:

  • Total study population was 70,149 women
    • 6,502 (23.3%) drank probiotic milk before pregnancy
    • 11,221 (37.6%) drank probiotic milk in early pregnancy
    • 12,784 (32.2%) drank probiotic milk in late pregnancy
  • Preeclampsia: Only probiotic milk intake in late pregnancy was significantly associated with lower preeclampsia risk
    • Adjusted OR: 0.80; 95% CI 0.68 to 0.94 (P = 0.007)
  • Preterm delivery: Only probiotic milk intake early pregnancy was significantly associated with lower risk of preterm delivery
    • Adjusted OR: 0.79; 95% CI 0.64 to 0.97 (P= 0.03)

CONCLUSION:

  • Probiotic milk intake in early pregnancy is associated with reduced risk for preterm delivery
  • Probiotic milk intake in late pregnancy is associated with reduced risk for preeclampsia
  • The authors suggest that results may be the result of both a local probiotics-mediated effect and an effect on the systemic inflammatory response
  • This present study can only assess association and RCTs are needed to assess a causal relationship and to look at different strains in probiotic milk

Learn More – Primary Sources:

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

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Related ObG Topics:

Are Probiotics Useful for the Treatment of Vulvovaginal Candidiasis?
Aspirin Treatment for Women at Risk for Preeclampsia – ACOG, SMFM and USPSTF Recommendations
Which Markers Can We Use to Screen for Early and Late Preeclampsia?

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