Early Pregnancy Probiotic Supplementation With Lactobacillus Rhamnosus
Alan Gaby, MD
Author: Wickens KL, et al
Reference: Early pregnancy probiotic supplementation with Lactobacillus rhamnosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial. Br J Nutr 2017;117:804-813.
Design: Randomized, double-blind, placebo-controlled trial.
Participants: Four hundred twenty-three pregnant women in New Zealand, 85% of whom had a history of atopic disease (asthma, eczema, or hay fever).
Study Medication and Dosage: Lactobacillus rhamnosus HN001 (6 x 109 colony-forming units per day) or placebo, beginning at 14-16 weeks of gestation and continuing until delivery.
Primary Outcome Measure: Incidence of gestational diabetes, diagnosed at 24-30 weeks’ gestation.
Key Findings: As compared with the placebo group, the incidence of gestational diabetes in the probiotic group was significantly lower by 68% (2.1% vs. 6.5%; p = 0.03) according to the New Zealand definition of gestational diabetes, and was non-significantly lower by 41% (8.2% vs. 13.8%; p = 0.08) according to the International Association of Diabetes and Pregnancy Study Groups definition of gestational diabetes. Using the latter definition, compared with placebo, the probiotic significantly decreased the incidence of gestational diabetes in women aged 35 or older (69% reduction; p < 0.01) and in women with a history of gestational diabetes (p = 0.004), but had no significant effect in women without these characteristics.
Practice Implications: This study demonstrated that treatment with a particular probiotic strain prevented the development of gestational diabetes in pregnant women. The beneficial effect was restricted to women who were over age 35 or who had a history of gestational diabetes. The mechanism of action is not known.