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

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?